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Social assistance administration in relation to dependency : a review of contemporary concepts of dependency… Macintyre, James McEwan 1957

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SOCIAL ASSISTANCE ADMINISTRATION IN RELATION TO DEPENDENCY A Review of Contemporary Concepts of Dependency and Public Welfare Administration, with Reference to the Administration of the Social Assistance Act by the City of Vancouver Social Service Department. by JAMES McEWAN MACINTYRE Thesis Submitted i n P a r t i a l Fulfilment of the Requirements for the Degree of MASTER OF SOCIAL WORK in the School of Social Work Accepted as conforming to the standard required for the degree of Master of Social Work School of Social Work 1957 The University of B r i t i s h Columbia i v ABSTRACT The problem of the cost of dependency i n public welfare has recently motivated many areas to make special studies to determine ways i n which i t might be reduced. The studies of Bradley Buell and associates have brought to the fore that i n any community there i s a comparatively small group of families which make use of the majority of health and welfare services i n that community. This study was designed to determine the size of the dependency problem i n Vancouver and to evaluate the public welfare'agency's attempts at combatting any problem that might exist. After reviewing the history of public welfare and the treat-ment of assistance recipients, attention was directed toward present-day concepts and ways of combatting dependency i n urban areas. The extent of the problem i n Vancouver was examined by examining thenumbers receiving private and public agency aid. Two public assistance caseloads were examined to determine how long the cl i e n t s had been i n receipt of assistance, why they were"receiving i t , and how old they were. The organization and f a c i l i t i e s of :the City Social Service Department were reviewed. Two research methods were employed: (l) reviewing the l i t e r a t u r e to determine how best to deal with the dependent group, and (2) s t a t i s t i c a l c l a s s i f i c a t i o n of two sample public agency caseloads and services given by private agencies. In-formation for this study was obtained from the Vancouver City , / Social Service Department records of assistance recipients, a ^Community Chest survey of the unemployed group i n Vancouver, current l i t e r a t u r e , and personal observations. In recent years, between one and two per cent of the population of the City of Vancouver have had to rely on the Social Service Department for their economic li v e l i h o o d . Most persons on assistance are medically unf i t for work although some recipients get tMs aid as they have to look after de-pendent children or are unable to get an old-person's allow-ance. Very good medical care i s given c l i e n t s , but-the size of,the caseloads i s such that i t i s d i f f i c u l t f o r workers to spend much time with any one c l i e n t to give continuing case-work help. It has been found that to adequately combat de-pendency,;.the various social agencies i n the community must work together. Individual diagnoses are needed to determine those who can be helped to become rehabilitated. In presenting t h i s thesis i n p a r t i a l fulfilment of the requirements fo r an advanced degree at the University of B r i t i s h Columbia, I agree that the Library s h a l l make i t f r e e l y available for reference and study. I further agree that permission for extensive copying of t h i s thesis for scholarly purposes may be granted by the Head of my Department or by'his representative. It i s understood that copying or publication.of t h i s thesis f o r f i n a n c i a l gain s h a l l not be allowed, without my written permission. The University of B r i t i s h Columbia Vancouver B, Canada. i i TABLE OF CONTENTS Page Chapter I. Public Welfare Concepts Relating to Dependency Approaches to the treatment of dependency. Current philosophy regarding public welfare standards agd the treatment of dependency. Definition of dependency. Social casework i n public welfare. A citizens' committee i n public welfare administration. Public welfare report-ing. Recent studies of dependency. B r i t i s h Columbia l e g i s l a t i o n for meeting social assistance needs. Purpose and focus of this study 1 Chapter I I . The Problem of Dependency i n Vancouver The extent of the dependency problem i n Vancouver. The cost of dependency. Characteristics of two Social Ser-vice Department caseloads regarding: reason for being i n receipt of assistance, age of recipients, length of time i n receipt of this aid. The role of the private welfare agen-cies i n Vancouver and services given 37 Chapter I I I . Vancouver's Approach to Dependency Organization of the Social Service Department i n Vancouver. Physical f a c i l i t i e s of the agency. Personnel f a c i l i t i e s . E l i g i b i l i t y requirements to receive assistance. Services available to those on assistance. Requirements from the person who remains on assistance 1. 53 Chapter IV. Conclusions and Recommendations P o l i t i c a l complexion of Vancouver. Need for a cit i z e n s ' committee i n public welfare. Future broadening of Department functions. Adequacy of allowances. Leader-ship i n the community. P i l o t project recommended. Indi-vidual family diagnosis needed. Need for public support of Department's a c t i v i t i e s 82 CHARTSiAND,TABLES IN THE TEXT Figure 1. Organization of Vancouver City Social Service Department 55 Table 1. The Cost of Administration of the Social • Service Department i n 1955' •• 41 Table 2. Analysis:of Social Assistance Expenditures j1955'• 42 Table 3. Extent of Basic Services Grben by Six Private Agencies i n Vancouver, December 1956 and January 1957 50 Table 4. Maximum Social Assistance Allowances..... — 4.... 69 Table 5. Composition of Social Assistance Allowances 69 i i i APPENDICES Appendix A. Bibliography. B. Tables. Table 6. Number of Social Assistance recipients by cases and individuals 1951-1956. Table 7« Social Service expenditures i n re l a t i o n to t o t a l expenditures of Vancouver. Table 8. Composition of Social Service expenditures 1929-1942. Table 9» Composition of Social Service expenditures 1943-1955. Table 10. Reasons given by persons applying for assistance i n two caseloads. Table 11. S t a t i s t i c s concerning two caseloads during the month of February 1957* Table 12. S t a t i s t i c s from the• Community Chest w •• survey of private agencies December 1956 and January 1957 regarding the problem of•the ^ unemployed employable group. C. Description of the setting i n which the persons l i v e i n the two caseloads studied. D. Distribution of Vancouver's social welfare costs. SOCIAL ASSISTANCE ADMINISTRATION IN•RELATION TO DEPENDENCY.. CHAPTER I PUBLIC WELFARE CONCEPTS RELATING TO DEPENDENCY One way of computing the degree of c i v i l i z a t i o n of a geographical area or an h i s t o r i c a l period i s to examine the extent to which i t s people are prepared to help those who are unable to look after themselves. In the Middle Ages i t was believed that the end of l i f e was to serve God and that this could best be accomplished by the upper classes accepting r e s p o n s i b i l i t y f o r the welfare of the poor. Alms were given under the guidance of the various parishes so that the miseries of the poor might be relieved. Dependency was looked upon as an honorable state. It was not u n t i l the fi f t e e n t h and sixteenth centuries that a def i n i t e stigma developed as a result of the large num-bers who asked for doles and alms. The so c i a l problem resulting from wide-spread dependency was reflected i n adverse attitudes to dependents. Within the dependent group was a number of "valiant rogues and sturdy beggars" who were subject to police measures as a result of their a n t i - s o c i a l behaviour. Those asking f o r public aid were looked upon with suspicion i n case they were not the worthy poor that they made themselves out to be. - 2 -The relatively good economic conditions of the seven-teenth and eighteenth centuries led to a situation in which relief was made as distasteful as possible for the recipient. Feelings of contempt were displayed by the general public toward those who had to request governmental aid for their livelihood. At the beginning of the twentieth century, the realiza-tion grew that scientific concern was needed to seek the causes for people becoming financially dependent on a state §gency. Social work as a professional discipline grew up at this time, also; when they had a better adquaintance with dependent people, social workers could then attempt to cure dependency in the i n -dividual case. In this way a body of knowledge was evolved re-garding the causes and cures of dependency. When a clearer picture of the extraneous causes of dependency was developed effective remedies could then be evolved and a bdginning made in the fight against dependency. The depression of the 1930*s led to a c r i t i c a l analysis of the working of the economic system and showed i t s wastes and maladjustments. Social insurance was seen as a f i r s t line of defence with social assistance being available to f i l l the gaps made by people who for any reason are not covered by insurance programs.""" Social insurance has been defined as the program which 1. de SCBISTEINITZ, K., "Social Work in the Public Services", Social Work Journal, yol.xxxvi, no.3, July 1955* P»89«. "insures people against and compensates them for, loss of income due to various causes, and thereby seeks to provide an economic security which will help to make direct assistance unnecessary".* Social assistance, on the other hand, is com-posed of cash, goods or services provided to or on behalf of an individual on a means test basis because he and his family lack the necessities of lif e compatible with decency and health. The first has a contractual quality about i t as i t involves a system of regular contributions. Social assistance, however, is simply given at time of need arid, comes directly from taxes paid by the general public. It was the depression experience which brought humani-tarian principles into the country's legal framework of social welfare. Many statutes reflected the belief that there was a subsistence level below which no one should be asked to attempt to live without help from a public welfare agency. This base, or subsistence level, was established so that those who could not fare so well in the economy would be looked after by those who could. It gave meaning to the belief that in a democracy each is his brother's keeper and is responsible for his neighbor. In the last twenty years certain groups of people have been singled out for categorical assistance. Children, war widows, blind 'persons, victims of industrial accidents, the aged and the handicapped now have individual programs for financial 1. BUELL, B., Community Planning for Human Services, Columbia University Press, New York, 1952. p.22. - 4 -assistance. General assistance i s now thought of as aid to needy persons not e l i g i b l e for one of the categorical programs. The l a t t e r usually have higher benefits than the residual assistance program. Today, we are s t i l l i n a transitional process i n which many of the ideas and superstitions of the past remain. Old attitudes die hard and remain to haunt those who endeavour to effect change. The basic c o n f l i c t i n the public mind s t i l l ap-pears to be i n connection with the question "Are dependent per-sons r e a l l y i n need and worthy of tax-supported aid, or are they i n that predicament due to a lack of desire to do any better?". . This i s the biggest block today to a more enlightened s o c i a l policy i n public welfare. It w i l l continue to be a block u n t i l the public i s made aware, through s c i e n t i f i c studies that give v e r i f i a b l e conclusions, that dependency does not spring only from personal weakness. Traditionally, need has been associated with personal inadequacy and moral weakness, as well as physical and mental incapacities. There i s s t i l l a good deal of suspicion that a person asks for assistance because of w i l f u l idleness, and could f i n d a job and support his family i f he r e a l l y wanted to; The-public i s s t i l l a fraid that assistance may be both too easy and too generous, so that those who receive i t w i l l not ever want;to work again. The taxation issue i s also ever-present i n that tax-payers equate higher assistance rates with;increased?taxation. J Current Philosophy Regarding Public Welfare Standards and the Treatment of Dependency Today i t i s a widely held b e l i e f that public assistance should be viewed as means to an end rather than as an end i n i t s e l f . The purpose of public assistance i s to help the person when he i s down and set him back on his feet. Present day ad-ministrators, r e a l i z i n g this, must see their agency's role as helping the so c i a l assistance recipient to return to being a self-maintaining and s e l f - r e l i a n t member of the community. They re a l i z e that they are doing the recipients an i n j u s t i c e i n l i m i t -ing their workers' function to merely determining i f each c l i e n t i s e l i g i b l e f o r assistance. Any assistance program, i f i t i s to serve the purpose of helping the recipient to be an inter-dependent person, must allow i t s workers enough time to recognize the individual or family's capacity for action and judgments. It i s necessary to explore what factors led the person to become dependent. i Throughout much of i t s history public welfare has con-fined the majority of i t s efforts to the a l l e v i a t i o n of distress. L i t t l e thought, has been given to • the; causes of '• the distress. It i s only i n recent years that<the'"bread alone"'concept has given way to the concept that dependency can only be reduced i f the administrators and workers i n the f i e l d keep their attention focussed on the causes and not merely'the r e s u l t s . 1 1. Cf. HILLIARDy R.M;, "Attacking Dependency;at its\Source", Public Welfare, v o l . 6 , no^2, February 1948. p.27. - 6 -Only as recipients grow i n the r e a l i z a t i o n that the agency on which they have "been forced to "become economically dependent does not demand a complete surrender of their rights as individuals w i l l they attain the incentive needed to overcome thei r situations i n whatever way they can. To do this, the agency must believe i n the concept of self-determination of the client•and acknowledge that people come to an agency to seek help with a wide variety and range of individual problems. A policy of c l i e n t self-determination i s needed so that c l i e n t s may make the choice which i s best for them after a l l sides of the issue are explored. The amount of the f i n a n c i a l assistance grant must be adequate. The person or family who has to direct a l l energies toward the process of daily l i v i n g cannot be expected to climb out of the dependent relationship." 1' Basic needs of food, c l o t h -ing and shelter are denied s a t i s f a c t i o n or kept at a low l e v e l when marginal rates of economic assistance are i n effect. The basic purpose of granting f i n a n c i a l assistance i s to r e h a b i l i -tate the individual so that he^can take care of himself. This goal cannot be achieved by adding the problem of inadequate funds to the problem that prompted the person to have to ask f o r finan-c i a l aid. The purpose of public assistance.T the person to help himself - i s forgotten when inadequate'assistance grants are made. s i . Cf. BESGEH, M.A., "Emotional Problems in,Dependency", Public Welfare, •vol;!!, no . 4 j A p r i l 1 9 5 3 ; ; p.53. •> '' - 7 -The means test hy which the person i s investigated i s the public agency's method of protecting the society i t re-presents against those who i t i s f e l t should not receive social assistance. Instances of persons not getting assistance after believing that they do qualify are lessened with the q u a l i f i c a -tions being made public. In this way any c i t i z e n may easily determine i f he i s e l i g i b l e or not. When a person i s found to be e l i g i b l e f o r public a s s i s -tance his essential needs should be met promptly and adequately. This can best be done by money payments i n the form of a cheque which the person may spend as he sees f i t . In some instances, as with alcoholics, i t may be necessary fo r the agency to ad-minister the assistance so that the cl i e n t might better l i v e within the amount that i s granted. The c l i e n t , rather than the bookkeeping section of the agency, should get the primary con-sideration i n such cases. The agency structure may unwittingly help to foster continued dependency of assistance c l i e n t s . The administration may overburden i t s workers with huge caseloads and low salaries 1 which threaten the workers' own security. Although i t i s a well-known and documented fact that many of those i n receipt of social assistance need only^financial aid, i t i s only when he has enough time to spend on :each case that the'worker can determine'theIones:to which-he will'devote f l . ;Cf. BERGER, op.cit;, p.53. - 8 -his time and talents. I f administration i s considered as "a means to an end, a f a c i l i t a t i n g kind of a c t i v i t y which finds i t s only j u s t i f i c a t i o n i n the end product of the agency - ser-vice to c l i e n t s " , 1 i t follows that the administration must begin with an acceptance of the v a l i d i t y of the service being given and be concerned with how that service may be most e f f i c i e n t l y provided. The administrator, then, i n a public welfare agency must be concerned not only with the l e t t e r of the law but also with the s p i r i t behind the law. It i s to the administrator and his s t a f f that the public looks for the implementation of the goals of the statute l a i d down by the l e g i s l a t i v e branch of govennment, and i t i s to him that his s t a f f looks for guidance i n meeting that challenge. There i s a need to develop methods of administration that w i l l permit cl i e n t s to maintain th e i r personal status i n a manner consistent with the central purposes involved i n provid-ing s o c i a l assistance as a rig h t . The concept of right has both ethical and legal aspects. Right i s thought of i n connection with the "sense of a claim which some individual has upon the community f o r assistance" rather than being concerned with mat-ters of personal morals. The state's care f o r i t s dependent persons i s con-1. WHITE, R.C., Administration of Public Welfare,'American Book Company, New York, 195 u ' p.182. - 9 -i sidered "by enlightened people the world over as a measure of i t s c i v i l i z a t i o n and the care of i t s poor i s recognized as one of the "unquestioned objects of public duty"."'' Because he i s a human being and a member of a community, the person i n a demo-crat i c society may fee l entitled to expect f i n a n c i a l aid when his circumstances warrant i t . The legal right to assistance has been c l a r i f i e d by the provision f o r special appeals and the fact that need and e l i g i b i l i t y have been defined by statutes. No matter what his rights may be or how legitimate his plea, the person applying f o r assistance w i l l usually f e e l humi-l i a t e d by having to ask for help. As i n any human situation, the person who feels himself to be inadequate or senses that others have the same opinion w i l l have a sense of humiliation. To pre-serve the in d i v i d u a l 1 s integrity, pride ahd self-respect i s of prime importance. This must be forever remembered i f the person i s to be truly helped to become again self-sustaining. Assistance must be so given as to strengthen the c l i e n t ' s sense of duty to stand up to the ordinary burdens of l i f e rather 2 than to release him from that duty. The giving ,;of f i n a n c i a l aid must be seen as a strengthening function for the c l i e n t rather than as a way of making him weak and further dependent. The way the social worker functions can either foster the cl i e n t ' s 1. Ruling Case Law 701, quoted by Edith ABBOTT i n "Is there a Legal Right to Assistance?", Social Service Review, v o l . x i i , no.2. p.260. 2. Guide to the Social•Services; = Family Welfare :Association, London, England, 1955' p.10. emotional dependency and f e e l i n g of helplessness, or i t can he used constructively to fan the flame of resourcefulness and help the individual to s t r i v e and seek fo r greater maturity. The "emergency r e l i e f " aspects of s o c i a l assistance are such that many persons asking for this type of welfare are seek-ing s o cial agency aid for the f i r s t time. Previously, these people were able to manage by themselves. The public welfare agency administering f i n a n c i a l aid should, more than others per-haps, have trained and experienced social workers. Professional social workers are essential for s t a f f i n g the intake section above a l l others. It i s here that the treatment process begins. Ideas and impressions obtained by the c l i e n t i n the f i r s t i n t e r -view w i l l remain with him and determine to a very large extent the way i n which he i s able to use constructively the agency's help. Workers should be cognizant to a certain degree of their own personality make-up that they may foster the f i g h t relationship with their c l i e n t s . The. worker must be aware of his own attitudes toward public assistance recipients i f he i s to help them to b u i l d new adaptive patterns to replace the old ones. Definition of'Dependency The public welfare programs present i n the North American"community:today place the individual making use of them - 11 -i n a dependent relationship to the agency* The dictionary d e f i -n i t i o n of dependency - the act of relying on, or subject to something else for support - i s representative of most persons* feelings toward the person i n receipt of a service supported by the government. Many persons assume that economic and emotional de-pendency are always i n juxtaposition to one another. These per-sons believe that a l l who must ask for f i n a n c i a l aid also need » services for emotional problems. In r e a l i t y , however, service i n public assistance agencies might be said to f a l l into one of the following three categories. Some persons asking for finan-c i a l assistance need only help i n securing this assistance, some need help with environmental problems, and some need help w^th emotional problems. There i s often an overlapping between these categories. Financial help at the time i t i s most needed may be a l l the service- that ah individual or family may require from a pub-" l i e welfare agency. Such individuals would be those who'were . able to use their own resources i n solving any other problems that might exist. This group would require casework services only to enable i t s members to make application for assistance. The provision of a monthly cheque i s not, however, enough for many families. A continuation of f i n a n c i a l aid only might lead to continued dependence which would be expensive i n - 12 -both monetary value and feelings of fru s t r a t i o n and unhappiness. Giving help with environmental problems involves "the location and use of those resources that are most appropriate to the needs of the particular family, whether they are to be found i n the community at large or within the family".'1' Some families might need only the supportive help of a social caseworker to enable them to make f u l l e r use of such resources. The t h i r d group of families or individuals includes those who need help i n dealing with attitudes that prevent them from using t h e i r own or outside resources e f f e c t i v e l y . In this group are found those persons known most often to social agencies i n the community, as they must draw on outside help to function at even a rather low l e v e l . This group has been described as having "markedly passive, dependent attitudes and few ego strengths". For this reason any help given must be a combination of s k i l l , patience and objective steadiness of purpose. Owing to their history of deprivation, f r u s t r a t i o n and defeat i n the l i f e process, these persons are unable to make use of fi n a n c i a l or other re-sources offered to them without this aid being accompanied by thorough casework services. I t can be seen that there are varying degrees of re-cipients' dependency on the public welfare agency i n the com-munity. Mechanical devices or forms designed to diffe r e n t i a t e 1. MIKTOK, E., "The Effect of Setting on Casework Practice i n Public Assistance",.Social Casework, xxxvii, no.2. p.66. 2. MBJTONj o p i c i t . , p.67. - 13 -between those needing only f i n a n c i a l aid and those needing other social welfare services usually f a i l i n the attempt. Experience has shown that individual case diagnosis i s the only method for d i f f e r e n t i a t i o n . Social Casework i n Public Welfare Social casework cannot be considered a thing apart from the administration of an agency as i t i s a way of giving the agency's services to i t s c l i e n t s . After analyzing many previous definitions, Swithun Bowers defined social casework as: "An art i n which knowledge of the science of human relations and s k i l l i n relationship are used to mobi-l i z e capacities i n the individual and resources i n the community appropriate for better adjustment be-tween the c l i e n t and a l l or any part of his t o t a l environment."! When applied to public assistance agencies, i t i s readily seen that the motive behind the use of soc i a l casework i s the prevention of pauperization of those people who have to depend on these agencies f o r t h e i r l i v e l i h o o d . The objective i s to prevent the person from becoming permanently dependent on public assistance and tp help him to make use of his own resources so that he may return to a more normal way of l i v i n g . As i n a l l other settings where he has a role to play, the social worker i s a helping person, and the way he helps 1. BOWERS, S;, ''The Nature • and Definition of Social Case-work",' 'Journal - of' Sibcial Casework,, noi8, October 1949* p.8._ - 14 -determines the use the individual c l i e n t can make of the service "being offered. The casework method i s the tool used by trained workers with their c l i e n t s to help them to help themselves. The trained s o c i a l worker i n the public welfare agency i s attempting to meet one of the great challenges i n the f i e l d of public welfare when he attempts to help people receiving f i n a n c i a l aid to once again become self-supporting. He does this through the aid of casework and by r e f e r r i n g the c l i e n t to other agencies i n the community where his needs may be better met. The basic philosophy on which social work i s based i s a b e l i e f i n the worth of every individual, i n his potential f o r growth and change, and i n his right to f i n d the most sa t i s f y i n g s o c i a l adjustment f o r himself and the community. The worker uses a relationship between the c l i e n t and himself to effect a change i n the c l i e n t . The relationship used i n casework might be des-cribed as the professional meeting of two persons f o r the purpose of assisting one of them, the c l i e n t , to make a better and a more acceptable adjustment to the problem which motivated him to ask f o r help. In many cases a relationship must be established be-fore a c l i e n t w i l l f e e l free enough to speak of the underlying problem of which asking f o r f i n a n c i a l assistance i s no more than an attempt at reducing the symptoms. The use of casework i n the administration of a public welfare program, such as s o c i a l assistance, i s a task of selection. - 15 -Rather than assuming that a l l recipients of f i n a n c i a l aid re-quire close supervision and intensive service, i f available or not, each case should be evaluated as soon as possible after intake that the correct degree of participation by the case workers may be given to be most beneficial to the c l i e n t . I t must be remembered by those who administer a public welfare program that no matter how s k i l f u l the various members may be, casework i s a poor substitute for an adequate income. Casework can never be a t o t a l solution for the problems of pover-ty. Professional social work i n public welfare settings must include community organization as well as casework so that the needs of the cli e n t s may be better met. Stimulating the com-munity to action on behalf of i t s c l i e n t s should be a most im-portant function of the administration of any public agency. I f social workers are to use their professional knowledge i n the formulation of the community as well as the individual agency, they must develop s k i l l i n organization as well as i n personal contacts.* A'Citizens' Committee i n Public Welfare Administration The value of a ci t i z e n s ' board i n government is'one of the majbr issues in'public assistance today. Persons interested only in<the efficiency of ;the welfare department decry the value 1; ;- BURNETT* M.Ci, ."The Role of the Social Worker i n Agency-Community, R e l a t i o n s h i p s P r o c e e d i n g s National Conference of  Social Workers, Columbia University Press, New York. p.675. - 16 -of such, hoards and prefer that direct responsibility he placed on a commissioner or director appointed by the head of the l o c a l government, municipal, provincial or federal, and removable by him at w i l l although tenure usually determined by "good behavior". Those interested i n community organization and i n interpreting the department's work to the citizens recommend a representative board of publ i c - s p i r i t e d persons who stand before the community as responsible for appointing the commissioner and for i n t e r -preting the work of the department. A compromise between these two positions would promote a plan f o r an advisory board of citizens with no power over the a f f a i r s of the welfare department but with an intimate under-standing of i t s a f f a i r s and a mandate to interpret i t s work to the public. This type of board proves to be very useful where the agency executive i s a man of v i s i o n and s k i l l to lead and develop such a group as a means of interpretation. Unfortunately, however, very few o f f i c i a l administrators possess the s u f f i c i e n t amount of s k i l l or understanding of the art of community organi-1 zation to make f u l l use of such a board. Professor Wayne McMillen believes that an appointed board of l o c a l citizens who do not have to depend upon holding the position f o r their l i v e l i h o o d i s the best medium through which to interpret a public welfare program. The administrative body he envisions would be composed of persons f e e l i n g that they •li -KHTG, Clarence, Organizing f o r Community Action, Harpers, New York, 1948. p.77. - 17 -had "been "asked to serve" as a " c a l l to duty" and who realized that public service needs representative control.^ The function of an advisory committee to a public wel-fare agency, or services which such a committee might he properly asked to render would include some or a l l of the following: 1. Help to raise the standards of service of the agency. Some members might be experienced welfare board members and be familiar with good standards. Sub-committees might be estab-lished to gather information on such matters as qualifications of personnel, standards of r e l i e f , preferred number of persons oh a case load that adequate service might be given. Findings would be presented to the agency executive for consideration. In this way help would be given i n the formulation of po l i c i e s f o r the department. 2. Establishing and improving relationships with other l o c a l welfare agencies. Misunderstandings among agencies are s t i l l prevalent i n the majority of communities. Many misunder-standings may be said to arise because of lack of knowledge about each agency's function, the role i t sees i t s e l f as playing i n the larger community. 3 . Assist i n interpreting the agency's program to the community. The task of interpretation may not be stated i n so many words but the responsible authority always hopes that the appointment of such a group w i l l "help to allay c r i t i c i s m i n 1. Cf. McMILLEN, W., Community Organization for Social  Welfare, p.77. • - 18 -the community and.....promote sympathetic understanding of the work".* Prom the community organization standpoint, the i n t e r -pretation of social security programs i n general and the plan f o r the l o c a l agency i s the chief contribution of any advisory com-mittee attached to a public welfare department. 4 . In general, the advisory committee would be ex-pected, to endeavour to maintain an e f f i c i e n t service to people i n need and to those who pay the b i l l - the tax-payers. Section III of the B i l l creating the State of Washing-ton's Department of Social Security reads, i n part, that "advisory committees shal l make such studies of l o c a l conditions i n the f i e l d of social security as w i l l enable them to make recommenda-tions r e l a t i v e to improvements i n general l i v i n g conditions and i n the administration of public assistance to the end that there w i l l be a lessening of the need of public assistance i n that county".^ Were the Province of B r i t i s h Columbia to enact similar l e g i s l a t i o n some thought would have to be given to who would be asked to serve on the advisory committee either at the provincial government level or that of the municipality. James Brunot i n an address to the National Conference of Social Work some years ago stated that he believed the question 1. McMILLM, op.cit., p.80. 2 . Quoted i n Education for Social Understanding, G. HAWKINS, American Association for Adult Education, New York, 1940. p.114.-- 1 9 -with, which to start the selection of advisory committee members should be "lhat persons i n the community can be counted upon to serve as active, interested and i n t e l l i g e n t board members?". He does not believe that selection should be based primarily on different groups, sections, or shades of opinion present i n the community.'*' From the group of persons selected after the former question i s posed, i t should be able to pick and appoint a group who w i l l be i n touch with a wide range of viewpoints and who w i l l be respected members of the community. Persons with established prestige and known human impulses are the most effective argu-ments for an agency's work when they become associated as c i t i z e n participants.*" The c i t i z e n participant i s a nucleus of a segment of public relations. The personal acquaintance of the committee member with o f f i c i a l s , p o l i t i c a l leaders, labour leaders, newsmen, businessmen and other i n f l u e n t i a l people results i n a d i f f u s i o n of information and attitudes about public welfare services. Public relations may be accomplished the best by subtle sugges-tions which emanate from lay and professional persons who are i d e n t i f i e d with the agency i n the eyes of the community. 1. BRTJ10T, J., ; "The Board Member i n a Public Agency", National Conference of-. Social' Wcbrk Proceedings* Colujnbi a Uni-v e r s i t y Press, New York, 1941• p . 6 1 4 . • • 2. This is;R; G. White's'term;for the'man or woman who serves-as:a :board member, -member of•a committee;'or'a volunteer worker; that'is*to say*•it iincludes those not employed1as s t a f f members•of;ah-agency.! For' further idiscussion'see :Administration - of Public 1Welfare; 1 American Book Company,;New•York; 195°• pp .448ff• - 20 -Public Welfare Reporting Public welfare i s social work charged with the support of the public at large. It i s a community function provided to meet community needs. It must, then, remain responsive to changing needs, resources, and attitudes as to public responsibility for using public resources. Public welfare agencies need to be understood by as many of the local citizens as possible. The continued existence and gradual improvement of basic services depends to a very great extent upon public support and approval. No changes can be made, for example, in the amount of money that assistance recipients receive until the elected representatives in Victoria and Vancouver are aware that the persons who elected them are desirous of such a change being implemented. Improvements in any public service, welfare or other, must wait upon wide endorsement from the electorate. The public agency interested in social action that better services might be given i t s clients must have interpreters as a bridge between i t and the community. The agency personnel usually know where they are going in relation to services to the community; i t i s of l i t t l e importance i f only agency members have this asset i f the citizens i n the community have but the vaguest notion of the need and the work being accomplished. The community needs a sense of participation and a basis of understanding. Indifference or open h o s t i l i t y on the part of - 21 -the citizenry i s , in part at least, the result of faulty or i n -sufficient interpretation of what exactly the agency is trying to do. Those charged with the administration of public welfare programs are in a position of stewardship to the community and should feel a sense of responsibility to provide i t with oppor-tunities to evaluate the agency's performance. Annual reports are a potentially important medium for advancing the public relations objectives of an agency. These reports should not be of aids to only elected government o f f i c i a l s under whom the department operates by stating s t a t i s t i c a l l y the events of the year, but should also be written with a view to enlisting public interest. Separate reports may be necessary for the varying needs of these two interested groups of people. The main reasons for annual reports are: to show the agency's- accomplishments; to describe the agency and i t s function; to suggest the relationship between the work of the agency and the well-being of the community; to analyze problems confronting both the agency and the surrounding community; to indicate plans for the forthcoming year; to account for funds spent; and to provide enough data that the community may be able to evaluate the work accomplished. The executive of the agency should be responsible for the preparation of the annual report but that does not presuppose that 1. Cf. McMILLEH, op.cit., p.296. - 22 -he w i l l write i t in i t s entirety. A report from each unit or de-partment written by i t s director w i l l afford a review and analysis by each sub-executive of his department's operations. If any service is necessary, the tax-payer i s entitled to reports of at least annual frequency as to how the service may be made more efficient and constructive. Traditionally, public welfare services have played a rather passive role in public relations; however, to continue in this way i s to lack knowledge of modern thought with respect to the responsibilities of those selected to administer state-authorized programs. By placing responsibility for decisions affecting social work programs with the community, individual social workers can es-cape the onus attached to "social reform". Resistance to change i s manifested i n any community asked to move in any direction before opportunity has been given to allow i t to prepare i t s e l f . The com-munity must be willing and want to work toward solving a problem before i t w i l l become mobilized for constructive action. Recent Studies of Dependency In the last decade, increasing attention has been placed on those families whose members have made use of community agencies as a way of meeting their needs. Bradley Buell and associates made a study in 1 9 4 8 of St. Paul, Minnesota, directed towards the major problems to which - 23 -community-supported services were directed: dependency, maladjust-ment, i l l - h e a l t h and recreational needs. This study revealed that 6.1 per cent of a l l families in the City of St. Paul had such serious problems to lead them to absorb over one-half of the services offered by the community's health and welfare agencies. These families ac-counted for 77 per cent of the r e l i e f load of the public welfare agency, 51 per cent of the health services and 56 per dent of the load carried by agencies in the mental health, correctional and casework fi e l d s . In San Mateo County, California, the Community Research Associates i n a contemporary study showed that 5»8 per cent of a l l families in that area are absorbing over 50 per cent of the social welfare resources available. A Winona, Minnesota, study showed that the services of the 46 local and state agencies reached but 12 per cent of the families in the county. This small group of families was discovered to be requiring a greatly disproportionate share of the money, time and s k i l l available through welfare services.''" Berthold Marcuse in a recent Master of Social Work Thesis made a reconnaissance study of long-term dependency and maladjustment cases in the Family Service Agency of Vancouver in an attempt to find causal relationships i n the families. He found multi-problem families and potentially-chronic cases to be susceptible to early identifica-tion. His study was a beginning to identify the etiology of malad-1.. BUELL, B., Mental Hygiene, vol . 3 9 , no.3, July 1955,PP*365-375. - 24 -justinent and dependency. Health, pre-marital behaviour, and socio-economic factors were examined by Mr. Marcuse in his evaluation of why some persons do become chronically dependent.* These studies point to the need for community-wide action on the part of every social agency within the community to combat the nucleus or "hard-core" group of persons who must use the sex— 2 vices to such an extent. It has been suggested that there i s a pressing need for experimental development of systematic proce-dures on a community-wide basis to ensure: 1. Early identification of the families and continuous systematic recording of data about them. 2. Integrated diagnosis of the total range of the problems which confront each family unit. 3. Classification of the rehabilitative potentialities of families as well as individuals. 4. Coordinated organization and direction of the special-ized services needed to achieve these potentialities. , 5. Periodic review and objective evaluation of the con-tinuing agency programs which are related to this group of multi-problem families. During the summer of 1951, Dr. Kermit T. Wiltse, of the University of California, made a study of the validity of social work techniques in the administration of a public welfare program in California. The following summary of his recommendations are meant as guides which apply to the relationship between the case-worker and the client of a public assistance agency. 1. MAECUSE, B., Long-term Dependency and Maladjustment Cases, Master of Social Work Thesis, University of Bri t i s h Columbia, 1956. 2. BUELL, B., Community Planning for Human Service, op.cit., pp.414-415. - 25 -(1) The family must he kept in perspective: the inca-pacitated father i n the family should not he forgotten, he should be helped to hold onto or regain the father role as the North American culture defines i t and with which reasonable harmony is necessary to one's personal adjustment. (2) Agericy policy insofar as i t tends to promote con-siderable overdependence on home v i s i t i n g should be adjusted to encourage discriminating use of home v i s i t i n g and office interview-ing. The client having to keep an appointment at the agency office has responsibility placed on his shoulders for his problem and he can better realize that i t is up tb him to do something about i t . (3) Workers and supervisors should make special attempts not to shelve clients either permanently or temporarily. "Very often only the worker's unswerving conviction that the person can recover his health or enough of his courage and strength to do some-thing different communicates i t s e l f to him and i s enough to make the difference between continued dependendy and renewed effort."''' (4) Public agency workers must realize their own feelings toward persons having to ask for financial aid. Workers should be helped to increase their a b i l i t i e s to value the people who come for help. A willingness to give resulting from genuine concern is demon-strated concretely to the applicant for assistance when he i s able to get every bit of assistance to which he i s entitled. This con-tributes significantly to the client's sense of value that he is 1. WILTSE, Kermit T., Social Casework in Public Assistance, California Department of Social Welfare, 1952. - 2 6 -able to gain renewed strength, to enable him to reach out for a more active and responsible relationship with his environ-ment . (5) I f a worker senses i n his relationship with a particular c l i e n t that no progress i s being made, he may well be trapped i n a f u t i l e battle of the w i l l s ; the more energy he puts into trying to win his point, the more energy he mobi-l i z e s i n his c l i e n t to defeat him. Having made such a d i s -covery, i t i s best i f he makes a complete s h i f t i n his approach to the particular c l i e n t . The State Department of Public Welfare i n Texas began what was c a l l e d "Operation Diagnosis" i n 1947 i n an attempt to meet the problem of too-large caseloads and the need fo r case-work services i n many situations. This project was meant to be a f i v e year one, but was extended to seven years. Step one of Operation Diagnosis was to teach the diag-nostic process to the existing s t a f f of social workers as a primary focus of s t a f f development. The workers were asked to make diagnostic summaries of a l l their cases; these were de-signed to show the workers* diagnostic thinking-through of facts and observations about the problems and their'causes. It took more than the o r i g i n a l l y intended f i v e years of practice on the part of the s t a f f and supervisors to attain diagnostic s k i l l in'the summaries. The second step was attained when the s t a f f i n the f i e l d became convinced that the casework relationship was the best-means of helping the c l i e n t i n a l l situations. This brought, too, a r e a l i z a t i o n of the v a l i d i t y of the fact that a l l c l i e n t s do not need the same degree and amount of service. Step three was the beginning of use of a no-narrative schedule f o r e l i g i b i l i t y recording. Similar to the form i n use . i n B r i t i s h Columbia this schedule examines the applicant's assets under the headings of: homestead, other real property, personal property (cash, stocks, bonds, livestock, etc.), insurance, present income of s e l f and immediate family, debjts owing. A set of instructions from the State o f f i c e i s ^ available i n each o f f i c e i n the f i e l d t e l l i n g how to use the schedule. When recording must be done for c l a r i f i c a t i o n i t i s done on the right hand'side of the e l i g i b i l i t y schedule. No record other than the schedule i s kept when a person applies for assistance. Step four was attained when the item method of bud-getting was discarded i n favour of a f l a t figure i n eight d i f -ferent l i v i n g situations plus medical and shelter.costs. The various figures for these areas i n which the person i s proved .to be e l i g i b l e and the amount of the grant i s then computed. Step f i v e was the inauguration of the e l i g i b i l i t y schedule. - 28 -I f i n the diagnostic process i t i s determined that the c l i e n t needs only f i n a n c i a l assistance (or that i s the only service that the agency can make available f o r that person) the streamlined nd>-narrative e l i g i b i l i t y schedule i s used during the annual interview."'" In this way there i s no dictation to be recorded, no backlog of untranscribed recordings, no f o r -gotten and uncleared e l i g i b i l i t y factors. If the diagnosis points to the need for casework services i n addition to those given while e l i g i b i l i t y i s being determined, the administrative framework "provides the worker time fo r the patient, consistent, and slow-moving pace often 2 required i n that process". Recording continues f o r this second group of cl i e n t s but content of records i s kept to approaches to the treatment goals, reactions of the c l i e n t , evidences of the casework relationship, and movement of the individual towards solution of his problem. A revalidation form i s completed at the time of the interview f o r further assistance and no further recording i s necessary i n f i n a n c i a l aid only cases. In other casework situations i t i s used for e l i g i b i l i t y purposes at intervals when revalidation i s required. This one-page form i s used only f o r the review of active cases and not i n the or i g i n a l 1. Once each year for Old Age Assistance and Aid to the Blind, twice each year f o r Aid to Dependent Children. 2. CURRIN, M., "Operation Diagnosis - providing casework i n large caseloads", Public Welfare, vol.12, no.4, October 1954, p.133. - 29 -establishment of e l i g i b i l i t y . This form i s the current ex-tension of material previously recorded. It i s designed not to report again and again narrative material or facts on forms already i n the record; only changes are recorded.^ It was found that the base budget and the stream-lined e l i g i b i l i t y schedule combined to save time i n establishing an applicant's e l i g i b i l i t y . B r i t i s h Columbia already has the f o r -mer, but i n the l i g h t of further work done to v e r i f y the bene-f i t s accruing from the change, Vancouver would do well to give the lead to the administration of S l c i a l Assistance i n B r i t i s h Columbia. A four month's project determined that after the changeover a case requiring continuing casework service help had 7 times the weight of a financial-service-only case. While 7 5 per cent of Aid to Dependent Children families were found to need continuing services, only 8 per cent of the Old Age Assis-tance category did.^ It was found, also, that certain geographical areas required more workers due to the volume of casework service units. It i s the usual administrative plan to divide an area by geo-graphical size and number of cl i e n t s but the Texas experiment found jobs should not be budgetted on the basis of number of 1. Each f i e l d worker divided his caseload l o g i c a l l y into "other casework services" and "financial-need-only" cases. Uniformity was the (gleanings of the two terms. Supervisors checked their workers* c l a s s i f i c a t i o n s . 2. CURRIN, M., op.cit., p.136. - 30 -oases; rather, they should he budgetted by the characteristics of the individual caseloads. Staff development benefits resulting from the Texas program include the freeing of the social workers from such routine drudgery. The s t a f f found that they had time to take a closer look at the poverty of soc i a l resources i n many areas. The new program, i t was found, enabled workers to provide more focussed services to c l i e n t s . Workers' treatment s k i l l s also grew. Because i t has been discovered that many of the people who make use of community agency resources are i n receipt of fi n a n c i a l aid, the public agency which gives that aid might be expected to have a deep interest i n organizing the community fo r action to combat dependency. In Vancouver, the City Social Service Department i s the largest welfare agency and i t i s to that agency that persons unable to support themselves finan-c i a l l y must turn f o r aid. B r i t i s h Columbia l e g i s l a t i o n for Meeting Social Assistance Meeds The B r i t i s h North America Act, adopted i n 1867, gave the provinces major res p o n s i b i l i t y for social security i n Canada. Since that time, the only modification to the or i g i n a l d i s t r i b u -t i o n of r e s p o n s i b i l i t i e s that has been made was the 1940 amend-ment to give the Dominion exclusive j u r i s d i c t i o n over l e g i s l a -t i o n i n the f i e l d of unemployment insurance. The provinces were given j u r i s d i c t i o n over municipal a f f a i r s and they usually passed on welfare obligations to the lo c a l authorities. This was done either by enacting poor law statutes or by writing broad and general provisions into muni-c i p a l acts'. Responsibility for the care of the destitute was o r i g i n a l l y l a i d down i n Municipal Act i n B r i t i s h Columbia as belonging to the local area. In areas not organized as c i t i e s or municipalities the government accepted re s p o n s i b i l i t y . The doctrine of primary l o c a l r e s p o n s i b i l i t y for the poor was thus established. The growth of i n d u s t r i a l i z a t i o n and urban l i f e was such that by the end of the nineteenth century the l o c a l authori-t i e s proved unable administratively and f i n a n c i a l l y to deal with the increasingly complex problems i n the f i e l d of public welfare. The provinces, to ease the strain, began to operate mental hospi-t a l s , reformatories, tuberculosis sanitoria, homes for the aged and infirm and other specialized services. In some cases, the provinces allocated funds to municipalities and private organi-zations to operate such programs.^ When the depression of 1929 occurred, B r i t i s h Columbia, i n common with other areas, was unprepared. In the f i r s t i n -stance responsibility was passed down to the lower le v e l of 1. CASSIDY, H. M., Social Seourity and Reconstruction i n Canada, . Ryerson, Toronto, 1943- p.20. 2. CASSIDY, op.cit., p.21. - 32 -municipal government. Refuge was sought i n the appointment of business men's commissions to examine the situation and their recommendations for more "belt-tightening" and reduction of public services received l i t t l e support. Public demand in s i s t e d upon higher levels of government taking action as the munici-p a l i t i e s were threatened with bankruptcy. In 1933, the Unemploy-ment Relief Branch i n Ottawa was formed under the direction of the Labour Minister. Plans for grants-in—aid to municipalities were completed and the government embarked on a scheme to provide for those lacking l o c a l residence qu a l i f i c a t i o n s . In this way the provinces bore a large part of the fi n a n c i a l burden of re-l i e f , although they were backed by the Dominion Government. Dominion grants to assist the provinces and munici-p a l i t i e s i n meeting the cost of unemployment assistance were discontinued early i n 1941. The system of provincial grants to the municipal le v e l continued to assist the l o c a l areas i n meet-ing the costs of assistance to either employable or unemployable persons dependent on the State f o r ' t h e i r existence. In 1943, the B r i t i s h Columbia Department of Health and Welfare was formed with a deputy minister appointed f o r each branch. Included i n the Social Welfare Branch were unem-ployment r e l i e f , Mothers' Allowances, aid to unemployables and Old Age Pensions. The la s t mentioned had been administered since i t s inception by the Workmen's CompehsatiorifBoard. With - 33 -the formation of this new Department the provincial govern-ment became more generous to the l o c a l areas and assumed 80 per cent of the cost of direct assistance. It extended this to the cost of children i n foster homes and f o r certain types of cases requiring special medical care i h boarding and nurs-ing homes. Precluded was the cost of unemployment r e l i e f which, as stated previously, was considered to be a Dominion resp o n s i b i l i t y . The Social Assistance Act of 1946 made legal pro-v i s i o n f o r the granting of aid to any "individual, whether adult or minor, or to families, who through mental or physical i l l n e s s or other exigency are unable to provide i n whole or i n part by the i r own efforts, through other security measures, or from inoome and other resources, necessities essential to maintain or assist i n maintaining a reasonable normal and healthy exis-1 2 tence". This Act defines "social assistance" as: (a) Financial assistance: (b) Assistance i n kind: (c) I n s t i t u t i o n a l , nursing, boarding or foster home care: (d) Aid i n money or i n kind to municipalities, boards, commissions, organizations, or persons providing aid, care, or health services, and i n reimbursing expenditures made by them: (e) Counselling services: (f) Health services: (g) Occupational training, retraining, or therapy f o r indigent, persons and mentally i l l or physically handicapped persons: (h) Generally any form of aid'necessary to relieve d e s t i -tution and suffering: 1; Revised Statutes of B r i t i s h Columbia, 1948;'Chapter 310, Sec. 3. 2. Revised Statutes, op.cit., Sec. 2. - 34 -^he Municipal Act of B r i t i s h Columbia states that i t "shall he the duty of every c i t y and d i s t r i c t municipality (of over ten thousand persons) to make suitable provisions for i t s poor and des t i t u t e " . 1 Before any such municipality may be helped f i n a n c i a l l y by the provincial government, i t must "pro-vide and maintain social assistance and r e l a t i v e social adminis-trative services on a basis consistent with the standards established by the rules and regulations made pursuant to this 2 Act". In this way the provincial government i s able to i n s i s t on a certain level of competence i n services offered to assis-tance c l i e n t s . A one year residence rule prevails i n B r i t i s h Columbia. The Residence and Responsibility Act gives authorization for persons not l i v i n g i n the loc a l area where their residence has been established, to apply f o r and receive assistance from another area i n B r i t i s h Columbia where they are presently permanently or !temporarily residing. The costs of these services, other than administrative costs, may be-charged to the l o c a l area where the person's residence has been established. A l l persons ..who become a President : of; a local"area i n accordance with the provisions of;the Residence and Responsibi-l i t y Act are said to remain a resident'of that area u n t i l they become residents of other l o c a l areas•or u n t i l they have'remained outside the province for a period year. • 1. Revised Statutes, Chapter 232. 2. Ibid. - 35 -The Purpose and Focus of this Study It i s proposed that this study w i l l examine the administrative policy by which the Social Service Department of the City of Vancouver i s administering the B r i t i s h Colum-b i a Social Assistance Act and to see how i t relates to depen-dency i n Vancouver. Various concepts of dependency as may be found i n current social work l i t e r a t u r e w i l l be reviewed and their findings applied to the administration of the Social Service Department. An attempt w i l l be made to evaluate the services offered by the Department to determine i f they are geared to help those who are dependent on the City for their economic liv e l i h o o d to regain their independent status i n a constructive manner and i n such a way as to respect individual dignity and worth. Rather than studying individual cases as a research method, this study proposes to examine the administrative policy that permeates the whole department. Costs of assistance w i l l also be explored. . In short, the research question that this study at-tempts to answer i s "To what extent have Vancouver's p o l i c i e s i n administering public assistance kept up with p r a c t i c a l s o c i a l work knowledge of the issue of dependency i n r e l a t i o n to the - 36 -handling of Social Assistance recipients?". Appreciating that the degree of readiness to accept social work and social workers i n any community i s related to that community's attitudes towards human values and democratic goals, and that the services offered i n the community simply r e f l e c t what the public i s w i l l i n g to st r i v e for, the leader-ship given by the City Social Service Department i n Vancouver toward public education for social action must be examined. CHAPTER II • THE PROBLEM OP DEPENDENCY IN VANCOUVER Vancouver i s a unique c i t y i n many ways. The great majority of the population of- the province l i v e i n close proxi-mity to this largest of i t s c i t i e s . Vancouver i s a hustling seaport situated at the end of the transcontinental railway systems* It i s to this c i t y that many persons employed i n seasonal occupations gravitate during the winter months. Per-sons i n other types of trouble, too, seem to f i n d their way to Vancouver where they hope to fare better. There are an estimated 2000 drug addicts i n the Van-couver area. Sixty-five per cent of a l l convictions under the Opium and Narcotics Act occur i n B r i t i s h Columbia. Two thousand addicts i n a c i t y of less than 500>000 add up to more than one addict for every 250 c i t i z e n s . This gives/Vancouver the highest drug addiction rate i n the Western Hemisphere.1 Too, this e s t i -mate gives Vancouver^more addicts than are found i n the entire remainder of the Dominion with a population of 1 5 , 0 0 0 , 0 0 0 . Vancouver's suicide rate i s three or four times the national figure. The divorce rate i s three.times the national average and juvenile and adult crime has the highest rate i n 1. PORTERj McKenzie, "The Dope Craze that's Terrorizing Vancouver", Macleans, February 1, 1955• Canada. Although i t has-dnly 8 per cent of the t o t a l popula-tion, 18 per cent of the court convictions occur i n B r i t i s h Columbia. Vancouver has one of the highest frequencies of vene-real disease and illegitimacy."*' There are an estimated 8000 alcoholics i n Vancouver City. Although some of them l i v e i n the skid-row area hy no means the majority of them do. The rate of alcoholism per 1000 2 adults i n a l l Canada i s 16; i n B r i t i s h Columbia this rate i s 26. Although Vancouver i s a prosperous young c i t y and i s the Western Canadian export centre, many of i t s citizens are unable to support themselves by their own endeavour and must rel y on s o c i a l agencies for f i n a n c i a l aid. Both public and p r i -vate agencies i n Vancouver give f i n a n c i a l aid to those i n need who meet e l i g i b i l i t y requirements. The City of Vancouver Social Service Department, the public welfare agency i n the City, maintains monthly s t a t i s t i c s to show the number of people who received assistance during that month, how many family-units were i n receipt of this help, and the costs which the City and province share. No other s t a t i s t i c s are kept at this time. 1. These figures were quoted by Dr. G. H. Stevenson, Direc-tor of the University of B r i t i s h Columbia's narcotic research programme, to the Annual Meeting of the Victorian Order of Nurses, Vancouver, March 7, 1955* 2. P0PHAM, E. E., A S t a t i s t i c a l Report Relating to Alco- holism and the Use of Alcoholic Beverages i n Canada, published by the Ontario Alcoholism Research Foundation, 1954. Table 6 shows the number of family-units or cases and the numbers of individuals i n receipt of assistance under the Social Assistance Act during the years 1 9 5 1 - 1 9 5 5 - 1 The figures include persons i n Vancouver nursing homes who are i n receipt of assistance. Although i n i t s e l f of limited value, a rate can be struck on the number of persons receiving assistance i n the City. In 1951, 1 3 . 4 3 persons per 1 0 0 , 0 0 0 were i n receipt of social assistance i n Vancouver. This number dropped to 10.07 per 1 0 0 , 0 0 0 2 i n 1953 t>ut increased to 13 .87 again by 1955« During the f i r s t three months of 1951» there was a steady increase i n the number of persons on assistance, but from A p r i l u n t i l September the number decreased slowly. Between October 1951 and February 1952, the number rose again. Through-out most of 1952 the number of individuals on assistance decreased. This pattern continued, except f o r increases i n DecBmber 1952 and January 1953, u n t i l December 1953 when the number rose again. The number of persons receiving social assistance grew quite steadily between January and A p r i l 1954, but remained com-paratively steady from May to October before once more r i s i n g i n November and December. In 1955, ^P-e number on assistance i n -creased from February u n t i l May, and lessened from June u n t i l October; there was a small r i s e i n numbers i n November, Decem-1. See Appendix B, Table 6 . 2 . See Appendix B, Table 6. - 40 -ber's figure was s l i g h t l y less than the previous month. As Table 6 indicates, the number of persons receiving assistance from the Vancouver City Social Service Department i s slowly decreasing. At the end of December, 1955, " t n e number of persons on assistance was fewer than the number receiving this service i n January 1951* 1953 appears to have been the best recent year insofar as i t had the fewest average number of r e c i -pients on a twelve month basis. Although numbers have increased since 1953, the 1955 average was not so high as the 1951 average. The Cost of Dependency to the City of Vancouver The share of the cost of i t s dependent citizens as-sumed by.the City of Vancouver may be found i n the Financial  Statements and Annual Reports of the City. As might be expected, there has been a steady r i s e i n the Social Service Department ex-penditures for the years 1943 to 1955• The r a t i o of social ser-v i c e expenditures to the t o t a l expenditures f o r Vancouver, however, has remained constantly between two ahd three per cent during those years. It would appear that the expenditures of the Social Service Department have grown apace with the other expenditures of the C i t y . 1 An examination of the almost $ 1 , 0 0 0 , 0 0 0 expended by the Social Service Department i n 1955 shows that general adminis-tra t i v e costs met by the City were s l i g h t l y less than $ 3 0 0 , 0 0 0 . 1 . See Appendix B, Table 1. - 41 -Actual social assistance ( f i n a n c i a l aid) costs amounted to over $658,000. This second number represents the City's proportion of assistance costs only. 1 The cost of administration f o r the year 1955 i s com-2 puted from the following figures i n Table 1; Salaries $240,359.20 Workmen's Insurance 42,417*19 Unemployment Insurance 579*92 Superannuation Fund 15,256.23 Separation Trust Fund 3,521.79 Medical Services 1,388.52 Stationery, printing and o f f i c e supplies 6,285.94 New Office equipment 811.41 Telephone service and telegrams 6,577*56 Bank charges 634*90 Travelling expenses 805.56 Auto- maintenance 9,599*62 New automobiles 4j794«97 Moving to new building - East Unit 32.60 Miscellaneous ^ 9IO.74 $333,976.15 The item "sal a r i e s " on the above table represents salaries for the workers hired by the City only; i t does not include the payment to workers hired by the Provincial Govern-ment placed with the City. The fact that most contacts between c l i e n t s and workers occur i n the homes of the c l i e n t s accounts, i n part,. 1. The provincial government reimburses the City to the amount of.80 per cent of actual assistance costs; the figure given here i s the remaining 20 per cent of the costs accepted by the City. In 1955 the social assistance costs of $2,300,589 were paid by the provincial government. The administrative costs are also shared by the province i n that i t has agreed to place a s o c i a l worker i n i t s employ within the City Social Service Department fo r every worker hired by the City to administer the Act. 2. Financial Statements and Annual Reports, City of Vancouver, 1955, P*38* - 42 -for the t r a v e l l i n g expenses incurred by the department of a l -most $11,000. The s o c i a l assistance figure of $658,118 i s arrived at by.computing the costs of the various services given by the Social Service Department, i n itemized account of the money spent within the "social assistance" heading i n Table 9 i n 1955 shows • the following expenditures.* Table 2. Analysis of "Social Assistance" Expenditures, 1955»  Cash support $538,774.56" Medical services 89,468.56 Medical supplies 5,945*89 Drugs 52,949.10 Housekeeper services 2,579*46 Indigent burials 12,243.45 Transportation 4,618.96 Ambulance services 3,754*80 Moving 984.90 Miscellaneous 45*96 $711,365.64 Less .Old Age Pensions assigned (net) 53,247.55 $658,118.09 Prom this table i t may be readily seen a large pro-portion of the funds of the Social Service Department goes to meet the qpedieal needs of c l i e n t s . When the amounts for medical services, medical supplies, drugs and ambulance services are t o t a l l e d along with the housekeeper services, i t i s found that they form over 28 per cent of the social assistance costs. 1. Ibid. Table 9 i s i n Appendix B. - 43 - • The $3,280,60.01 cost of operating and giving services from one agency for one year i s only a part of the t o t a l picture of dependency i n Vancouver. This figure includes only the con-crete and measurable components of dependency. Feelings and emotions cannot be measured so easily. Other independent studies have attempted to examine i n a more detailed way the effects on 2 the personality of continuing dependency on a social agency. The cost to Vancouver of i t s dependent citizens does not stop with the addition of the various amounts of money needed to run a social welfare department and the amount of f i n a n c i a l aid given to those i n need. Characteristics of Two Social Service Department Caseloads Centre Unit i s divided into six'geographical divisions with one social worker assigned to each area. In February 1957• the six areas had 126, 134« 1335 145 a n ( i 1^ 4 single persons or heads of families i n them. The average caseload at that time was 145 persons. The caseload studied"^ as being the most representa-ti v e of the Unit had 126 c l i e n t s : 106 men and 20 women. Twelve of these persons were l i v i n g with a spouse and children ( i f any); the remaining 112 persons l i v e alone. 1. 1955 figures show the costs to be divided as follows: $980,000 from the City and $2,300,589 from the Provincial Government. 2. H00S0N, W., The Rehabilitation of Public Assistance Re- cipients, Master of Social Work Thesis, University of B r i t i s h Colum-bia, 1953; MARCUSE, B., Long-term Dependendy and Maladjustment , Cases, Master of Social Work Thesis, University of B r i t i s h Columbia, 1956; EVANS, M., Living on a Marginal Budget, Master of Social Work Thesis, University of B r i t i s h Columbia, 1953. 3. Hereafter, this caseload i s called "caseload 'A'", the West Unit caseload i s calied "caseload *B111. . - . West Unit, too, i s divided geographically for adminis-trative purposes into several areas with one social worker res-ponsible f o r each area. .The caseload chosen to be examined i s divided into two d i s t i n c t parts, each having an equal number of cl i e n t s . Sixty c l i e n t s i n this area l i v e i n nursing homes l i -censed by the Provincial Government and the City of Vancouver. The remaining 65 c l i e n t s are able to look after themselves or have relatives i n their own home to look after them. The 60 c l i e n t s who need special care l i v e i n 13 nursing homes. There are 27 women and 33 men i n these homes. With few exceptions, a l l the nursing home patients are over seventy years of age; only four were born after 1900. One of the four suffers from multiple sclerosis, one from disseminated s c l e r o s i s , one i s schizophrenic with marked paranoidal tendencies and the fourth has an incapacitating form of a r t h r i t i s . In general, the per-sons i n the nursing home half of this caseload suffer from d i -seases and illnesses most common to older persons. Only the 65 persons i n the other half of the caseload have been examined for this study. It i s this second half that i s compared with caseload "A," already mentioned. (l) Reasons given by persons asking for assistance •.• Only two persons from each caseload studied were re-ceiving assistance as being within the "unemployed employable" group. Three i n each caseload were waiting the granting of.- •" their Old Age Assistance or Old Age Security pensions. Within caseload "A", six women were classed as having dependent children and were unable to secure employment for this reason; some had applied for Mothers' Allowance and been refused. There were thirteen (25 per cent of the number of women) mothers with dependent children i n caseload "B". The greatest number of persons on assistance i n Van-couver are unf i t for employment. In caseload "A", a r t h r i t i s , physical injuries and tuberculosis account for almost one half the persons receiving a i d . 1 Physical injuries includes persons obtaining help after they have been involved i n an accident f o r which f i n a n c i a l compensation i s not immediately forthcoming. Victims of t r a f f i c accidents, for example, often do not appear i n court u n t i l a stage i n treatment i s reached whereby the degree of l a s t i n g effect may be calculated. The City i s usually re-compensed for a l l monies given to accident victims i f they are able to sue successfully the person responsible for their condi-tion. The factor responsible for the largest number of men > asking for f i n a n c i a l aid from caseload "B" i s some type of mental 2 condition. Eight women, 15 per cent of the t o t a l , suffered from a mental condition which made them d i r e c t l y or i n d i r e c t l y unable 1. See Appendix B, Table 10. 2. For the purpose of this c l a s s i f i c a t i o n , "mental condi-t i o n " includes persons suffering from psychoses, psychoneuroses and those having a limited mental a b i l i t y . Some have had i n s t i -tutional care and were referred to the City on being discharged. - 46 -to accept or keep employment. Like caseload "A", caseload "B" has a quite large group of persons recuperating from tuberculosis. Heart conditions of various kinds led about 10 percent of the persons i n each caseload to apply for assistance. (2) Age of persons on assistance"*" The most s t r i k i n g thing that i s noticed when examining the year of b i r t h of cli e n t s i n caseload "A" i s the preponderance of older men. Only 12 of the men were born after 1911 . Twenty-three were born between 1902 and 1910, 30 between I896 and 1901 . 2 Porty-one of a total of 106 were born before 1895. In caseload "B" ten women were under 35 years old, 9 were born between 1911 and 1920, and 18 were born between 1902 and 1910. These proportions are to be expected when i t i s realized how many of the women i n the caseload are i n receipt of assistance because they have children to look after. (3) Lgngth of'time persons have received'assistance In the two caseloads studied, 32 persons or families had been receiving assistance since before 1950; this i s 12 per cent of:the combined t o t a l . Twenty persons received assistance 1. See Appendix B, Table 1 1 . . 2 . Ten of these men are'over sixty-seven years of age and have either applied for an old person's allowance and are waiting to learn of their acceptance for i t ^ : or have applied and been re-fused i t as being ineligible•due to lack of evidence of correct age, lack of residence or some other q u a l i f i c a t i o n . f o r the f i r s t time i n January and February 1957• During 1956, thirty-one persons applied for and received social assistance fo r the f i r s t time. E a r l i e r figures have shown that the rate of dependency i s declining i n Vancouver. No figures are available to show the number of cases closed that remain closed for a year. The Role of Private Welfare Agencies i n Vancouver The foregoing has described the extent of the problem of those unable to provide f o r themselves f i n a n c i a l l y that i s realized by.the City of Vancouver public welfare agency. A recent study by the^Family and Child Welfare D i v i -sion of the Vancouver Community Chest and Council sub-committee organized to study the problem of the unemployed employable group i n Vancouver of six private agencies giving welfare ser-vices showed that many more persons are i n need than are known to the public agency. This research project, executed under the chairmanship of Professor James Weber Wilson, Faculty of Commerce and Business Administration at the University of B r i t i s h Columbia, examined the services given to applicants during the months of December 1956 and January 1957. It was o r i g i n a l l y hoped that i t would be a three-month study, but the agencies concerned did not a l l give the same degree of cooperation for various reasons, not the - 48 -least of which, was the time element involved i n f i l l i n g out the s t a t i s t i c a l cards. The six agencies cooperating for this study were: Central City Mission, Holy Rosary Cathedral, John Howard Society, Salvation Army, Sisters of Atonement, and F i r s t United Church. Persons assigned to intake i n these agencies were asked to do the following: ( 1 ) Give identifying information on each applicant. This includes name, age, address and occupation. (2) Classify each person into one of the following categories: 1. Unemployed employables who are l i k e l y to be e l i g i b l e for assistance through the Vancouver City Social Service Department; 2. Transients or out-of-the province cases who have been l i v i n g i n B r i t i s h Columbia f o r less than twelve months; 3. The older worker who i s experiencing problems get-ting or holding employment. Persons over 60 years of age were e l i g i b l e for this c l a s s i f i c a t i o n ; 4. Miscellaneous. This includes a l l those not covered in the f i r s t three categories; the marginal and inadequate worker who appears to be a chronically dependent person and unable to maintain himself. (3) Special comments concerning the person. This might i n -clude comments as to where the applicant was referred! for help i f i t could.not be provided by the agency. > (4) 'The number of beds or betl tickets, the number of meals or meal tickets, and the amount of cash given to the c l i e n t dur-ing" the research period. An estimate of the cost involved i n giving a man a free bed was computed; i t was usually 40 or 50 cents per night. The cost of meals was also computed and d i s -covered to be i n the neighbourhood of 40 cents. Together with the cash given to the person, these other services were to t a l l e d so that the amount of money the agency gave the c l i e n t i n goods or services could be arrived at. This survey was a basic one for' Vancouver; no similar survey had ever been undertaken of the private agencies. It was hot meant to be an a l l - i n c l u s i v e study, but merely one to deter-mine the extent of the problem i n Vancouver of the unemployed employable group and those who could not receive public assi s -tance due to their not meeting the e l i g i b i l i t y requirements i n B r i t i s h Columbia. The t o t a l number of recipients of services by the s i x agencies during the two month period exceeded 2700. Nine hundred and thirty-eight men received a t o t a l of 384O free beds. The average number of beds supplied to each man applying for a bed was 4*0$. Two thousand two hundred and t h i r t y men received a t o t a l of 7916 free meals. The average number of meals supplied to those applying for a meal was 3.55* The t o t a l cash value of a l l assistance granted to a l l recipients amounted to $5,630.33 for the two month period. The - 50 - . - . average cash value of assistance granted to each recipient amounted to only $ 2 . 0 6 . The following table shows how this l a s t figure was computed:1 Table 3« Services Given by Six Private Welfare Agencies December 1956 and January 1957»  Agency- Mo. of beds No.of meals Cash Value of A s s i s t Average value to each recip. City Mission 1460 1229 $ 751 .75 $ 3 . 5 0 Holy Eosary 309 420 8 2 1 . 8 5 I . 8 4 John Howard Soc. 308 823 8 3 0 . 3 5 4 . 6 2 Salvation Army 1280 3422 1989.23 2 . 0 8 Srs.of Atonement - - 8 4 . 0 0 • 5 0 2 F i r s t United Ch. 483 2022 1138.30 1.50 Total 3840 7916 $5630.33 $ 2.06 The study showed that a large number of men were known to more than one agency during the months the special records were kept. Assistance granted by these private agencies was meant to be f o r aid i n emergency situations. The small amount of money and services given i n most instances to persons i n need made i t such that a person not e l i g i b l e f o r public assistance 1. This table and the numbers used i n this section are from the unpublished findings of the Community Chest Survey of Vancou-ver's unemployed employable group for December 1956 and January! 1957• - 2 . Every agency i n this study but the Sisters of Atonement gives money, meals (by meal ticket or actual meal consumed on the premises) or beds (either by giving a ticket or bed to the client) to those who ask f o r such aid and who are i n need of i t . The Sisters of Atonement give sandwiches each day to those i n need. - 51 -had to v i s i t the different agencies to get continuing services. It was found that 6O5 men were known to more than one agency of the six studied. Four hundred and thirteen men were known to two agencies; of these, 233 or 56 per cent were c l a s s i -f i e d as "unemployed employables". Almost twenty per cent of the 413 had not established residence i n B r i t i s h Columbia, having come from another province within the l a s t twelve months. One hundred and thirty-seven men were known to three agenciesj 52 per cent of these men were "unemployed employables" according to the c l a s s i f i c a t i o n used. A further 20 per cent were from outside B r i t i s h Columbia. Of the 49 men known to four agencies, 28 of them were said to have been able to work i f employment could have been found for them. Table 12 shows1 that the average number of persons c l a s s i f i e d as "unemployed employable" amounted to 51 per cent of those asking for some form of help from the agencies. Twenty per cent of a l l applicants were c l a s s i f i e d as transients. It would appear, then, that despite the fact that the e l i g i b i l i t y requirements f o r Social Assistance have been widened to include unemployed employable persons i n the community, there are s t i l l many who do not receive this aid. There appears to be a distance between the philosophies of the private and public agencies i n Vancouver. The public 1. Appendix B. agency has i t s cl e a r l y and l e g a l l y defined function and role to play. Those who do not meet the e l i g i b i l i t y requirements for public assistance must try to eke out an existence with the help of the private agencies, their friends or strangers i n the street. The private agencies were o r i g i n a l l y set up to do emergency work of short duration rather than to accept responsibility f o r con-tinuing services to large numbers of persons who f a l l between the e l i g i b i l i t y mesh of the public agency. CHAPTER III VANCOUVER'S APPROACH TO DEPENDENCY In Vancouver the City Social Service Department ac-cepts responsibility for i t s needy persons under Section 344 of the Bylaws Vancouver Incorporation Act 1921, and amending acts r consolidated to 1936, which reads that "It s h a l l be the duty of the City to make suitable provision for i t s indigent and de s t i t u t e " . 1 The Vancouver Board of Administration which i s com-posed of two elected members (the Mayor and an Alderman) and « two appointed members (the City Comptroller and City Engineer) consolidated much of the committee work that was formerly common to Vancouver's c i v i c administration. The Board of Administra-tion makes recommendations to the City Council regarding action i t feels should be taken but, theoretically, the Council com-posed entirely of elected representatives of the citizens bf Van-couver determines policy that any di v i s i o n w i l l follow. The Administrator of the Social Service Department i s responsible, through the Board of Administration, to the City Council and the people of Vancouver. The Administrator has ultimate authority over his de-partment but i s responsible to the Board of Administration whose 1. A new Vancouver Charter was adopted i n the Spring of 1951'• I t i s not known at time of writing i f this wording was changed. support he must get for any changes he wishes to make. Unless both the City Council as a whole and i t s Board of Administration agree on any change the Administrator sees as being necessary f o r the welfare of the people of Vancouver, that change w i l l not be forthcoming. The Assistant Administrator i s second i n l i n e of authority i n the Department. In his o f f i c e i s vested the per- ' sonnel and business management of the Department. The sections and units of the social services report to the Assistant Adminis-trator f o r administrative purposes. The Welfare Director has mainly a s t a f f function i n the organization of the Department. She i s responsible f o r s t a f f development and occupies a consultative rather than a l i n e posi-tion. The Administrator, Assistant Administrator and Welfare Director form what i s known as the Staff Committee. To this Committee social workers may present cases which need special help. This may be for an additional allowance for a special rea-son or i t may be that the worker feels a more l i b e r a l amount of earned income should be exempted without tho cheque being ad-justed for the following month. The organization of the Department i s both geographical and functional. It i s organized geographically insofar as the City i s divided into four sections f o r administrative purposes - 55 -with four d i s t r i c t o f f i c e s . Functional organization, stressing the specialization of labour, i s also present i n that there i s a medical section, social work section, and o f f i c e services sec-tion. Each of these major a c t i v i t i e s forms the basis of a sepa-rate department. The social work and medical sections together form the seven social service divisions of the Department. The Medi-cal Section i s composed of nurses who are concerned mainly with obtaining medical histories and reports from physicians and hospitals as well as assisting c l i e n t s d i r e c t l y i n obtaining medical services and appliances. They also do placements i n boarding and nursing homes as vacancies occur. As mentioned above, the City i s divided into four sec-tions with an o f f i c e of the Department in each of the South, East, West and Centre Unit areas. The l a t t e r two Units are located i n the same of f i c e building which i s i n the West Unit area but only half a block from direct transportation to the heart of Centre Unit. Within each Unit each social worker has his or her own d i s t r i c t and i s responsible for a l l assistance cases i n that d i s t r i c t . For this reason, social workers on the Department's s t a f f are often called ' d i s t r i c t v i s i t o r s ' . Intake Section i s located at the main o f f i c e building which houses West and Centre Units. It i s to this quite separate section that persons apply for assistance. The Department's medical and intake sections are on the same f l o o r of the same "building, thus f a c i l i t a t i n g the cooperation that must he achieved between these units i n carrying out Vancouver's policy of giving assistance only to those medically u n f i t to work. The seventh d i v i s i o n of the Department's social ser-vices i s Taylor Manor, a home for Vancouver's senior c i t i z e n s . This residence offers boarding rather than nursing care f o r old persons who have resided for some time within the City of Van-couver. Within each d i v i s i o n (except medical and Taylor Manor) a Unit Director i s responsible f o r administrative matters and heads the d i v i s i o n . Directly under the Unit Director i n authority i s a Casework Supervisor who i s responsible for the services of-fered the c l i e n t s and who assists workers on s p e c i f i c cases through supervisory periods. Neither of these two o f f i c i a l s do direct casework with c l i e n t s and they do not make home v i s i t s . There are approximately nine d i s t r i c t workers i n each Unit who work d i r e c t l y with c l i e n t s . The whole Department has a t o t a l of 60 medical and social work employees. The o f f i c e services of the Department are divided into f i v e sections. As the name implies, the Records Section main-tains information on each recipient of assistance. As well as handling the detailed work of numbering and keeping the f i l e s i n good order, this section i s responsible f o r transporting - 57 -f i l e s to various units and to individual workers within those units. From the Control Section come a l l vouchers for the pay-ment of allowances or reimbursements for services to the City's c l i e n t s . This section i s also the source of approval f o r board-ing and nursing homes for special cases and of payments for various charges, e.g., b u r i a l expenses, inquests, coroners' i n -quiries. Accounting "A", the t h i r d d i v i s i o n of the o f f i c e ser-vices, prepares the monthly a f f i d a v i t and supporting documents necessary for the calculation of the Provincial Government's share of costs. Accounts are also prepared i n this d i v i s i o n to be sent to those other B r i t i s h Columbia municipalities whose former r e s i -dents are i n receipt of assistance i n Vancouver. Accounting "A" receives and deposits cheques from these other centres when they arrive. Statements are prepared for the City's accounting and internal audit divisions. Miscellaneous c l e r i c a l work associated with cheque preparation and bank account reconciliations i s also done by the d i v i s i o n . Accounting "B" i s responsible for writing emergency cheques and f i r s t payment cheques for those starting on assistance and v e r i f i e s these cheques against the voucher f i l e . A most im-portant duty of this d i v i s i o n i s the role i t plays i n helping older c l i e n t s to obtain their b i r t h c e r t i f i c a t e s from places outside Vancouver. This d i v i s i o n also processes requests f o r stationery and supplies within the Department. Staff Meetings Combined Staff Meetings are held once a month at the main o f f i c e building. These meetings are primarily concerned with st a f f development and a l l s t a f f attend. The programme usually consists of a talk by a representative from another health or welfare agency. When st a f f members are sent as dele-•i gates to national or regional conferences they are asked to give ah address to the other s t a f f members when they return. The individual units also hold s t a f f meetings. These are under the direction of the Unit Director and are usually held once a month. After administrative business had been dealt with, the unit members may take over the meeting and have a general discussion on some aspect of the agency programme or the wider social work f i e l d . More discussion i s l i k e l y to evolve i n Unit meetings than those for t o t a l s t a f f , as they are smaller and the members know each other more intimately. Physical F a c i l i t i e s of the Social Service Department The physical f a c i l i t i e s of Vancouver's public welfare agency are good. Recently two new buildings were erected by the City f o r i t s East Unit and main o f f i c e s . Only South Unit has not been changed. It remains as a vestige of the not so distant past when i t was f e l t that assistance recipients did not "deserve" anything better than having to l i n e up i n back lanes while they waited for their cheques. - 59 -The recent building programme has taken public welfare . . . . ! out of "store fronts" to buildings designed exclusively f o r social welfare purposes. Both new buildings are as up to date as any modern o f f i c e building being b u i l t i n Vancouver. The be l i e f that c l i e n t s are people and deserve pleasant surroundings has d e f i n i t e l y shown through i n the planning of the new buildings. The main o f f i c e building, located one block from the intersection of two of Vancouver's most important t r a f f i c arteries, houses the Intake Section, Medical Section, West and Centre Units, as well as the Accounting and Control Sections and the adminis-tra t i v e o f f i c e s . Room i s also available for large and small meetings i n the Conference Room and sub-basement Auditorium. Persons applying for assistance have the comfort of private offices i n which they may be interviewed. Although con-versation may be heard i n the next room, more privacy i s afforded than previously was the case. When a social worker i n either West or Centre Unit wishes to interview a cli e n t i n the of f i c e he may use semi-private cubicles or an off i c e meant for an u n f i l l e d Supervisory position. I f i t i s not possible to use a private o f f i c e , the c l i e n t may be interviewed i n the main o f f i c e where a l l social workers i n the Unit have their desks. This large room i s adjacent to the Infor-mation Desk but doors cut off the sight of cli e n t s being i n t e r -viewed from that quarter. - 60 -Intake and Medical Sections are located on the same f l o o r i n a wing at right angles to the main building. Centre and West Unit, the Records Section and Stenographic Pool are located on the second f l o o r where the cheques are issued. Ad-ministrative offices and f i n a n c i a l and bookkeeping personnel are a l l located on the top f l o o r of the main o f f i c e building. Both East Unit and the main o f f i c e building also house Metropolitan Health Units. Their administration i s quite apart from that of the Social Service Department. East Unit i s func-t i o n a l l y designed and i t s most s t r i k i n g feature architecturally i s the large amount of glass used and the i n t e r i o r courtyard i n the middle of a square of o f f i c e s . As previously mentioned, only South Unit located above an old Fi r e Hall remains as a vestige of the former days of social welfare i n Vancouver. Personnel F a c i l i t i e s of the Social Service Department The success of any programme, so c i a l welfare or other, depends to a very great extent on those who are hired to give the service. The social workers s t a f f i n g Vancouver's public wel-fare agency might be said to be i t s greatest asset. They appear to be actively interested i n doing the best job possible on be-half of their c l i e n t s . The City would prefer to hire social workers as d i s t r i c t v i s i t o r s who have received professional training at recognized Schools of Social Work, but the lack of social workers i n the community has lead to the need for h i r i n g persons without this training. A l l supervisors i n the various units have had some university training i n post-graduate social work; two Unit Direc-tors have also had the benefit of this form of training. New workers are given a short in-service training course as a means of orienting them to the work of the Department. This course i s given by senior s t a f f persons. It i s the policy of the Department to pay i t s workers for the position i n the organization rather than for past t r a i n -ing when they start to work. In this way, persons with a Bachelor of Social Work degree would receive the same starting salary as the person having a Bachelor of Arts degree. Persons with more social work training, however, might expect to ascend faster to supervisory positions. City personnel are paid at higher rates than most so c i a l workers i n Vancouver and d i s t r i c t . The City has given leadership i n this area believing that the best services are given by the best workers who should be attracted to public assistance work by adequate salary scales. Vancouver's E l i g i b i l i t y Requirements to Receive Social Assistance Except during the winter months of 1955 a n ( i 195&, Social Assistance has been available i n recent years only to those - 62 -who, because of mental or physical i l l n e s s , were unable to sup-port themselves by their own endeavours. Also included have been those prevented from working due to "some other exigency". The l a t t e r category includes those mothers of dependent children who have applied for, but not yet received, Mothers' Allowances and older persons who have applied for but not yet been accepted as e l i g i b l e for Old Age Assistance and Old Age Security. During the two winters mentioned, assistance was made available to persons i n f i n a n c i a l d i f f i c u l t y due to the seasonal unemployment charac-t e r i s t i c of B r i t i s h Columbia. Dominion-Provincial conferences led to the agreement between the senior governments that they should share the costs of unemployment assistance. The main c r i -t e r i a for e l i g i b i l i t y f o r this aid was i f the person had been offered and had accepted work suitable to him during the summer previous to his asking f o r f i n a n c i a l aid. Unlessrthe person could demonstrate that he did work when he could get i t , the problem leading to his asking help was not considered related to the una v a i l a b i l i t y of jobs. Because the federal government gives aid to this programme, the fact that a person did not have residence established i n B r i t i s h Columbia did not prevent him from receiving aid i f he had come to the province as a bona fid e working man believing he could f i n d employment. Persons wishing to apply for assistance from the City .must go i n person to the Intake Unit at the main o f f i c e building"'" 1. Social workers are also "on duty" at South-and East Units for receiving assistance applications forepersons l i v i n g i n those areas. The majority of applications are taken at the main o f f i c e b u i l d i n g . - 63 -and present a c e r t i f i c a t e signed by a physician. I f the person does not have his own family doctor, he may go to the Out-Patients' Department of the Vancouver General Hospital and be examined there. Confirmation from the Unemployment Insurance Commission of n o n - e l i g i b i l i t y f o r benefits must be produced. Cases that are the responsibility of the Workmen's Compensation Board are direc-ted to that o f f i c e . A person may, however, receive assistance from the City while his case i s being reviewed by this or other such Board; this i s another example of assistance being granted as a result of "some other exigency". I f an applicant for assis-tance i s i n the process of having his case reviewed by the Y/ork-men's Compensation Board he w i l l be asked to sign a guarantee of reimbursement for any assistance received i f his case i s found to be appropriate by the Board. Another group of questions that must be answered con-cern where the applicant has been l i v i n g . The applicant must be able to prove that he has l i v e d i n Vancouver for the last twelve months. I f he i s unable to do this , he must state where he has resided i n B r i t i s h Columbia i n recent years u n t i l residence of twelve months or more i s established i n any one municipality or i n Unorganized Territory i n B r i t i s h Columbia i f he has not stayed i n a town or v i l l a g e . Since the late 1940's, the City Social Service Department has been less s t r i c t i n i t s requiring a p p l i -cants to produce confirmation of their having l i v e d i n Vancouver. - 64 -"Acceptance of responsibility by municipalities and the Provin-c i a l Government had become so universal that those otherwise e l i g i b l e for assistance were able to get i t wherever they applied. A person having residence i n some other place i n B r i t i s h Columbia may be granted assistance i n Vancouver without his being sent back to the municipality or area where his residence has been established. A complex set of agreements exists between Canada's various provinces and i t i s possible that the person who seeks f i n a n c i a l aid from Vancouver may be repatriated to the pro-vince i n which his residence has been established. In some cases, where social reasons loom high, the person may be permitted to remain i n B r i t i s h Columbia although his residence has not been established i n this province. In these l a t t e r cases, he i s treated as i f he had residence i n unorganized t e r r i t o r y i n B r i t i s h 2 Columbia. Information about assets the person owns must be given. A l l that he owns must be l i s t e d as well as any anticipated income. To be e l i g i b l e for assistance applicants must have no more than $150 cash reserve i f they are single or more than $300 i f married; exceptions are made i n special cases, however, so that these 1. COLCLEUGH, M.C., Assistance to Single Unemployed Men, City of Vancouver Social Service Department Publication, Vancouver, B.C., 1955, P-33. This interesting, informative and v i t a l piece of re-- search was undertaken by Mr. Colcleugh who supervised the programme , of unemployment assistance i n Vancouver during the winters of 1954 and 1955. 2. This i s an administrative decision for the purpose of determining how much of the assistance given w i l l be the responsi-b i l i t y of the government of the province. See Appendix D. amounts of money are not, i n themselves, bars to e l i g i b i l i t y . The nature of recent employment must be revealed. The applicant must state when he was l a s t paid and-how much he was paid. He must be able to account for any recent pay, say what he spent i t on and, i f possible, furnish receipts f o r amounts spent for rent, doctor's b i l l s , clothes and so on. When the social worker i n Intake Unit i s s a t i s f i e d that adequate information has been provided to warrant assistance, the applicant i s asked to sign the application form swearing to the veracity of his statements. He i s also asked to sign a form giving the City of Vancouver permission to examine any bank ac-count that he might have. He i s then asked to return to his home to await a c a l l from the social worker who i s the d i s t r i c t v i s i t o r i n his area. Usually within the next two days a s o c i a l worker v i s i t s him. At this time the worker v e r i f i e s a l l statements made at the Intake Section, checks on the amount of rent paid and i t s due date, and v e r i f i e s any bank accounts that may have been declared. During this f i r s t home v i s i t , i t i s Departmental policy that the social worker f i n d out more about the c l i e n t to deter-mine how the Department may best be of service to him. At this time the worker i s able to t e l l the applicant i f he i s accepted as e l i g i b l e for assistance and when he may pick up his f i r s t and succeeding cheques. It may be more propitious that cheques be - 66 -mailed i f the person's i l l n e s s i s such that he cannot get around without much d i f f i c u l t y ; this, too, w i l l he decided during the f i r s t v i s i t . Cheques are issued at the end of each month f o r the month following. I f the recipient i s incapable of exercising proper control of his finances, his cheques may he issued weekly for one-quarter of the month's assistance. At one time the City had a worker dealing exclusively with the problem of alcoholism and alcoholics i n receipt of social assistance and he administered the cheques. With the advent of the Alcoholism Foundation of B r i t i s h Columbia i n 1954, this prac-t i c e was discontinued. Alcoholics must now get their cheques administered by a member of another social agency or a private c i t i z e n i f they prove unable to handle their assistance wisely.* Some alcoholics, then, get a cheque each week from the City and some get cash allotments from their personal administrators. It i s the individual social worker who determines how the cheque should be administered. „ • At one time the workers i n the Intake Section did a l l the necessary work involved i n the establishment of an applicant's e l i g i b i l i t y . Social Service Department cli e n t s now actively par-t i c i p a t e i n establishing their own e l i g i b i l i t y for assistance. 1. The Salvation Army of f i c e r s i n skid-row missions are most often asked to be of service i n this way. Contact i s maintained between the social worker and the volunteer adminis-trator. - 67 -It i s realized that persons applying f o r assistance do not want, and should not he expected to, surrender a l l their rights and privileges and are, therefore, expected to help and take; an active part i n this process. Applicants are expected, for example, to get their own medical c e r t i f i c a t e s stating the nature of their d i s a b i l i t y and bring them to the Intake Section when they apply for assistance. It i s the same with Unemployment Insurance clearance; applicants are expected to go to the libcal o f f i c e of the Commission to register and determine i f they are e l i g i b l e f o r benefits. Any applicant who feels that he i s e l i g i b l e for Social Assistance and who i s refused i t , has the right to appeal the intake worker's decision.. This right to appeal continues f o r the period of time the person i s i n receipt of assistance and any recipient may ask for a hearing i f he feels that he has received unfair treatment at the hands of a City worker. The person may apply i n writing to the Director of Welfare i n V i c -t o r i a for a review of any decision he feels affects him adversely. The Director then refers the appeal for a hearing to a Board of Review appointed for the purpose. The person l i v i n g i n Van-couver asking for an appeal w i l l have his case heard by a Board consisting of the Social Welfare Branch Regional Supervisor, a Public Health Dlctor or Nurse and a person the City who i s not i n the City's employ. The Board of Review transmits i t s recommendation on the case to the Director of Welfare; i f - 68 -this decision does not prove to be acceptable to the person a l l the facts are sent to the Provincial Secretary for a decision. Although the Social Service Department expects relatives such as husbands, wives, sons and daughters to help when possible, i t does not canvass relatives to determine their a b i l i t y to help The intake process usually takes three days. The f i l e originating i n Intake Section i s passed to Records aft e r the i n i t i a l information has been recorded. When i t has been num-bered and processed the f i l e goes to the Unit i n which the a p p l i -cant i s residing and a social worker makes the home v i s i t . The f i r ^ t cheque may be available the following day. The whole pro-cess has been reduced to one afternoon for cases of extreme need and urgency. Services Provided by the City Social Service Department The Vancouver Social Service Department administers, above a l l , a programme of direct f i n a n c i a l aid to needy i n d i v i -duals and families residing within the City l i m i t s either tempo-r a r i l y or permanently. The programme of the Department has several phases, the largest being direct f i n a n c i a l aid now cal l e d Social Assistance rather than " r e l i e f " . The amount of money paid each month to assistance recipients i s determined by the Provincial Government, but the c i t i e s and municipalities i n the province may give more than the maximums provide. The maximum - 69 -rates f o r Social Assistance recipients as increased i n A p r i l 1956 are: In this table "group" means the number of individuals i n the family unit; a man, wife and two children would, then, expect to get a maximum allowance of $108.50 with which to meet a l l f i n a n c i a l demands on them for one month with the exception of medical care costs. Assistance i s paid by cheque and each re-cipient may spend his money i n the way that best suits his needs as he sees them. Theoretically, however, the amounts of a s s i s t -ance granted are determined by adding the following allowances: Table 4 . Group Amount 1 2 3 4 5 6 $ 5 0 . 0 0 7 6 . 5 0 9 2 . 5 0 IO8.50 124.50 140.50 Table 5» Composition of Social Assistance Allowances. Miscellaneous Group Food Clothing,Opera-ting, etc. Total Support Shelter Total 1 $30000 $ 5 . 0 0 2 4 9 . 5 0 7 . 0 0 3 5 8 . 5 0 9-00 4 67 .50 11 .00 5 7 6 . 5 0 1 3 . 0 0 6 85.5O 1 5 . 0 0 7 9 4 . 5 0 17 .00 8 1 0 3 . 5 0 1 9 . 0 0 $ 3 5 . 0 0 5 6 . 5 0 67 .50 7 8 . 5 0 8 9 . 5 0 1 0 0 . 5 0 I H . 5 0 122 .50 $ 15 . 2 0 . 2 5 . 3 0 . 3 5 . 4 0 . 4 5 . 5 0 . $ 5 0 . 0 0 76.5O 9 2 . 5 0 108.50 124.50 140.50 156.50 172.50 The A p r i l 1956 increase i n Assistance rates raised the Group One amount from $45 "to $50 for a l l hut those whose spouses were i n receipt of Old Age Assistance, Old Age Security, Disabled Persons 1 Allowance or Blind Pension. In these cases, the Social Assistance rate was increased by only two dol l a r s . A person i n receipt of assistance who does not have to pay rent would not receive the part of his allowance that i s designated to be used for that purpose. Dietetic research has been carried out and i t has been determined that the food allowances as outlined are adequate for* persons to l i v e on. The theoretical allowances break down, how-ever, i n r e a l i t y . The rent allowance, for example, i s not ade-quate to allow an individual or family to reside i n any but the poorest room or suite. For this reason, persons on assistance have to spend some of their food allowance i n order to have a decent place to stay. Very few assistance recipients are able to f i n d housing at rates approximating their rental allowance. Medical Services The City of Vancouver interprets "health services" as le g i s l a t e d for i n the Social Assistance Act to include: physi-cians' services; hospitalization; drugs for which a prescription has been given; appliances such as eye-glasses, dentures, trusses and orthopoedic appliances; extra pre-natal allowance of f i v e - 71 -dollars per month for the last four months of pregnancy; trans-portation such as an ambulance to-hospital or taxi to a doctor's o f f i c e ; nursing and hoarding home care. The B r i t i s h Columbia Hospital Insurance programme came into effect i n 1949* Prom i t s inception u n t i l A p r i l 1954, "the Provincial Government paid the premiums for social assistance recipients. In 1954 "the e l i g i b i l i t y requirement for receiving benefits under this province-wide hospitalization scheme was changed to one of residence only. Any person who has resided for one year within the province of B r i t i s h Columbia i s e n t i t l e d to the services of the BCHIS scheme. The following benefits may be provided to those recom-mended as needing them by their attending physician: 1 (a) Public-ward accommodation; (b) Operating room f a c i l i t i e s , including the use of a l l equipment and material required i n the proper care of surgical cases; (c) Case room f a c i l i t i e s , including the use of a l l equip-ment and material required i n the proper care of maternity cases; (d) Surgical dressings and casts as required, as well as other surgical materials and the use of any equip-ment which may be required while i n hospital; (e) Anaesthetic supplies and the use of anaesthesia equipment; (f) Such drugs, prescriptions, and similar preparations as may be designated by the Commissioner from time to time; (g) A l l other services rendered by individuals who receive any remuneration from the hespital, provided that the provision for such services i n a particular hospital i s approved by the Commissioner. Services which may be approved by.the Commissioner'for the purpose of this clause may include:-1. B.C. Hospital Insurance Service, Annual Report 1955* - 72 -( i ) R a d i o l o g i c a l , d i a g n o s t i c , and t h e r a p e u t i c s e r v i c e s , i n c l u d i n g the s e r v i c e s of the r a d i o l o g i s t , ( i i ) C l i n i c a l l a b o r a t o r y and o t h e r d i a g n o s t i c prodedures, i n c l u d i n g the s e r v i c e s of a p a t h o l o g i s t , ( i i i ) The s e r v i c e s of an a n a e s t h e t i s t , ( i v ) P h y s i o t h e r a p y s e r v i c e s ; (h) Care of the acute stage of c h r o n i c d i s e a s e where, i n the o p i n i o n of the Commissioner, such c a r e i s neces-s a r y and d e s i r a b l e . A one d o l l a r per day charge f o r each day spent i n h o s p i t a l i s l e v i e d on B r i t i s h Columbia r e s i d e n t s , but each a s s i s t a n c e r e c i -p i e n t r e c e i v e s at the time h i s case i s accepted a M e d i c a l Card which enables him and h i s dependents t o any or a l l of the s e s e r v i c e s . T h i s c a r d i s a l s o used as a means of i d e n t i f i c a t i o n and must be shown b e f o r e any cheque i s i s s u e d . D e n t a l s e r v i c e s have a l s o been made a v a i l a b l e t o s c h o o l c h i l d r e n under e l e v e n y e a r s of age whose pare n t s are i n r e c e i p t of a s s i s t a n c e . N u t r i t i o n i s t A M e t r o p o l i t a n H e a l t h Committee N u t r i t i o n i s t s e r v e s as a c o n s u l t a n t t o the Department's s o c i a l w&rkers and me d i c a l s t a f f , Her o f f i c e i s l o c a t e d i n the Main O f f i c e b u i l d i n g and she g i v e s h e l p i n answering q u e s t i o n s r e g a r d i n g b u d g e t t i n g , meal p l a n n i n g , and s p e c i a l d i e t s . T h i s s e r v i c e h e l p s the workers t o h e l p t h e i r c l i e n t s t o s t r e t c h t h e i r a l l owances as f a r as p o s s i b l e . - 73 -Housekeeper Services A housekeeper may be brought into a home where i t i s f e l t advisable for an i l l person to remain at home, or where dependent children require temporary care due to the i l l n e s s of a parent. The housekeeper may move into the home or spend part of the day at the home having only certain daily tasks to per-form that are beyond the a b i l i t y of the i l l person and family. This service may be offered only after the d i s t r i c t s o c i a l worker has had the recommendation approved by the Staff Committee of the Department. At the present time this service i s rather sketchy as there are Sew housekeepers known to the Department and w i l l i n g to work fo r i t . Were there more house-keepers available i t i s f e l t that .they could be u t i l i s e d by the Department. Burial Services The City of Vancouver accepts the res p o n s i b i l i t y for funerals and burials of i t s assistance recipients. As f a r as possible this service i s conducted by the religious denomina-ti o n which-the person was a f f i l i a t e d with. Interment i s i n Mountain View Cemetery which i s operated by the Vancouver Health Department. . - 74 -Casework Counselling Services Social workers on the s t a f f of the Social Service Department i n addition to establishing and reviewing e l i g i b i -l i t y of persons i n need of f i n a n c i a l aid, are endeavouring to provide a continuing counselling service for them. They stand ready to help clients with personal and social d i f f i c u l t i e s as: It i s the goal of the City Social Service Depart-ment to assist needy citizens, by understanding and individualized service, to use resources within themselves and the community to achieve the greatest possible measure of self-independence.^ At present there are certain conditions preventing the Department from r e a l i z i n g i t s stated goal. As previous figures indicate, the size of individual caseloads increases during the winter months. In recent years when the plight of the unemployed employable group was f i n a l l y recognized and action taken to per-mit this group to participate i n the social assistance programme, no- additional workers were added to the staff to f a c i l i t a t e ser-vices at a time when caseloads were already larger. A result of this has been a marked reduction i n the number of quarterly v i s i t s paid to assistance recipients during the winter months. Workers have been forced to deal with emergent situations as they arose and have had to spend the greater part of their time i n processing new applications rather than being free to give case-work services on a continuing basis to existing recipients. 1. This statement was taken from a brochure outlining the City of Vancouver Social Service Department services printed i n A p r i l , 1956. (Soc S 130 M). - 75 -The determination of the size of caseload which a so c i a l caseworker should be responsible for that the best service at the least f i n a n c i a l and social cost might be given, depends on the particular situation of the agency. No universal optimum caseload for any type of social work can be established insofar as the way the agency defines i t s function with respect to the cl i e n t deter-mines the caseload'which any worker within the agency can carry .' e f f i c i e n t l y . "' A 1938 study by the Chicago Relief Administration which reduced caseloads to about 80 persons through the h i r i n g of additional caseworkers showed a net estimated saving of over 17 per cent after a l l the expenses of r e l i e f and costs of adminis-tration were paid.* This points to the fals e b e l i e f that economy i n the number of workers i n the department w i l l help to save the tax-payers' money and help to keep the mill-rate down. Good casework saves money for the community because i t i s constructive and returns more cl i e n t s to self-maintenance i n a shorter time than i s possible with no casework, or casework spread so thinly over a large number of people as to be v i r t u a l l y i n effectual. Caseload analysis has shown that few Social Assistance recipients i n Vancouver are not receiving medical care for some reason. Some recipients do receive f i n a n c i a l aid on compassionate 1. Adequate Staff Brings Economy, American Public Welfare Association, Chicago, 1939j. P«17' - 76 -grounds, women with dependent children and older persons await-ing categorical assistance, f o r example. Illness, then, i s a "major cause of dependency today. Too, those who are poor appear to suffer a higher incidence of disease by the very nature of the i r poverty. The two medical conditions found most commonly i n assistance recipients have probably had more research into their etiology than many other i l l n e s s e s . It i s a well-documented fact that there are psychological and psychiatric factors present i n the backgrounds of many a r t h r i t i c and tuberculous patients. Some 1 would argue that many physical i n j u r i e s are more than accidental. A r t h r i t i s , pnysical injuries and tuberculosis are conditions responsible for 35 P e r cent of the persons i n the Vancouver case-loads studied being on assistance. People, not bodies, get sick. Treatment must be geared to the individual person. In many cases the "greatest problem of a l l i s the paradoxical nature of the i l l n e s s that chooses for i t s most l i k e l y candidate the person who can emotionally least afford 2 to be sick". The a r t h r i t i c person's personality contributes to a large extent to his being a r t h r i t i c , for this reason treatment must be a matter of engaging the person i n a tot a l healing pro-cess that includes making a more healthy use of the forces that necessitated his becoming i l l . It i s i n this area that the s k i l l s . 1 . See Man Against Himself, ' 2 . SCHLEISS, B. G.,. "Social Casework Services to the A r t h r i t i c Patient", The Family, v.xxv, no.9, January 1945> p . 3 3 2 . of the social caseworker can make a significant contribution i f the time i s made available for the job to be accomplished. The social worker can help the person to deal with the problems of the r e a l i t y situation which interfere with his capacity to make the best use of medical care. Recognition that the care and treatment of a r t h r i t i s should be carried out i n hospitals or out-patient c l i n i c s under medical supervision i s needed, but this i s not enough. Social workers i n community agencies must "assume continued responsibility for enabling the patient to ac-cept the demands of treatment and for f a c i l i t a t i n g environmental measures that w i l l lessen the pressures and strains a r i s i n g from the patients' i n a b i l i t y to function normally".*'" Even i f ade-quate medical care was available i n the community for a l l i n need the task of getting the person to make use of i t would re-main. Concurrent with treatment the patient needs understanding of the jsrobilems and aims of treatment i n his particular case. Studies on the psychogenic make-up of the a r t h r i t i c patient have revealed certain rather characteristic neurotic trends,' heavily tinged with morbid anxiety, which existed as often before as after the development of the disease. Cobb, Whiting and Bauer after studying 50 patients with rheumatoid a r t h r i t i s found that i n 66 per cent of them there was a demon-strable 5 chronologic correlation between-emotional stress and 1. MARGOLIS, II. M., "Care of the Patient! with Rheumatoid A r t h r i t i s " , The,Family*'vol. xxv, no.9, January 1945. P-330. the attacks of arthritis."'' The emotional c o n f l i c t s must he helped he resolved as well as the somatic factors so that the emotional security i n the patient may he heightened. In tuberculosis, also, the speed and chance of re-covery of an individual depend to a great extent on his per-sonality. Wittkower states that i n some cases " i t may be safer to assess a patient's prognosis on the basis of his personality and of his emotional co n f l i c t s than on the basis of the shadow 2 on the f i l m " . Although the argument continues regarding the b e l i e f that tuberculous patients may or may not have certain features i n common, i t i s agreed that emotional disturbances often precede - and may precipitate - the onset of tuberculosis. Some have suggested that the advent of this particular i l l n e s s may be the outcome of intolerable intra-psychic c o n f l i c t s with their attempted but unsatisfactory solution. Writers have stressed the function of the i l l n e s s as a means of f l i g h t from fr u s t r a t i n g experiences and the r e s p o n s i b i l i t i e s of l i f e i n gene-r a l . ^ An unhealthy mode of l i f e and mental upset often precede the onset of symptoms. 1. Journal of the American Medical Association, vol.113, p.668, August 19, 1939' Other journals supporting these theories are:- Journal of Nervous and Mental-Disease, vol.85, p.637, June 1937j American Journal of Psychiatry, November 1936. 2. WITTKOWER, E., A Psychiatrist Looks at Tuberculosis, The National Association for the Prevention of Tuberculosis, London, 1949, p.138. This book gives the results of a research project i n which Dr. Wittkower was engaged. 3. See HERZ, J., "Tuberculosis and Personality Conflicts", Psychosomatic Medicine, No.6, 1944, PP.17-22;'and DAY, G;j "Some Observations on the Psychology of Tuberculosis", Lancet, Novem-ber 1946, pp.703-706. - 79 -Requirements of the Assistance Recipient i n Vancouver While an individual or family i s i n redeipt of Assis-tance from the City of Vancouver any and a l l changes i n circum-stances must he reported to the social worker i n whose d i s t r i c t the recipient i s l i v i n g . The f i r s t of the three main changes that most interest the Department i s that of any change i n the cl i e n t ' s address. If, for example, a person moved to a home where he paid no rent for his room, his cheque would have to be adjusted downward so that the rental allowance would not be included. The second change i s that the Department must be i n -formed of any and a l l monies received by the c l i e n t from any source. Each time a c l i e n t goes to his d i s t r i c t o f f i c e to get an assistance cheque he must complete an "Income Form" on which are declared any earnings or other income received during the l a s t 30 days.* I f some money has been earned, the person's cheque may be reduced. The amount of any unearned income, such as an annuity, i s also l i k e l y to be deducted from the assistance cheque. The Department feels that i t s cli e n t s should be encouraged to seek employment and a single person i s allowed to earn a t o t a l of $10 per month without his cheque being reduced. I f the per-son i s able to earn more than $10, however, 75 per cent of the excess i s deducted from the cheque. A single person's earned 1. Clients of Chinese or i g i n l i v i n g i n Vancouver's "China-town" pick up their assistance cheques at the YWCA i n that area; not have to f i l l i n Income Forms as, i n the main, their knowledge of the English language language i s so limited as to invalidate this procedure. - 80 -income and social assistance cheque may not exceed a maximum of $70; i f more, the person i s no longer e l i g i b l e f o r assistance. The basic exemption for heads of families i s $20 instead of $10, but this includes the earnings of a l l the family members. The 75 Per cent deduction on amounts exceeding $20 i s the same as for single persons, except i n special cases. Each cheque i s based on the declared earnings or i n -come of the previous month. The recipient i n Group 1 who earned $20 i n July would, then, have his August cheque adjusted by sub-tracting $7«50. This would give him an assistance cheque for $42 .50, plus the $20 he had already earned - a t o t a l of $62 .50. The t h i r d factor of importance to the Social Service Department i s that i t must be informed of any change i n the num-ber of dependent persons i n the household. If a member of the family either leaves or returns home, for example, this must be reported so that the assistance may be altered. The Department must be informed, also, i f a dependent c h i l d over 16 years of age stops attending school or terminates an educational corres-pondence course. Only i f such a c h i l d i s physically or mentally disabled can his parents continue to receive assistance for him after he reaches his sixteenth birthday. The War Veterans' Allowance programme affords an interesting comparison with Social Assistance i n regard to the - 81 -amount of allowable income each i s permitted. Like Social Assistance recipients, those on War Veterans' Allowance re-ceive aid subject to certain f i n a n c i a l limitations. The com-bination of other income and a WVA allowance may not exceed the appropriate annual income c e i l i n g . "Other income", however, does not include casual earnings from odd jobs, part time em-ployment to $50 per month, or temporary employment up to 12 weeks per year. A veteran or widow(er) of a veteran having single status may receive $60 maximum rate per month; the annual income c e i l i n g for this category i s $840. A veteran or widow(er) having married status may receive up to $108 per month with an annual income c e i l i n g of $1,440.^ The War Veterans' Allowances programme would appear to be more ready to recognize that some persons need considerable help to enable them to return to work. The Social Assistance programme, which has lower status i n the public mind, although desirous of helping persons return to work i n the way best suited to them, withdraws i t s support sooner; this may well cause some persons to prefer remaining dependent rather than r i s k i n g job f a i l u r e with a return of the humiliation surrounding the ex-perience of reapplying for assistance. 1. The $60 single person's allowance may be increased to $70 i n special cases, and the $108 married person's allowance may be increased to $120 also on a means test basis. Canada Year' Book, Dominion Bureau of S t a t i s t i c s , Ottawa, 1956. CHAPTER IV CONCLUSIONS" AND RECOMMENDATIONS Vancouver i s a c i t y with many social problems. The rapidly growing population combined with the cultural attitude of " l i v i n g big" and the "boomer" psychology of the City leads to the b e l i e f that Vancouver's problems w i l l increase. The problems of drug addiction, alcoholism and crime a l l stem from and contribute to the problem of dependency. A vicious c i r c l e operates to enmesh those unable to keep up with the pace set by those able to function i n this milieu. The p o l i t i c a l complexion of Vancouver does not augur well for the meeting of i t s so c i a l problems. There i s an a l -most complete lack of ferment of ideas* issues i n soc i a l welfare seldom appear. The whole subject has not had enough a i r i n g by the City. Vancouver citizens must be enabled to discuss their public welfare agency i n a knowledgeable way i f they are to. f e e l that their Department i s an integral part of the community. That this may be achieved, there should be more adequate commu-nication between the Department and the public. A citizens" committee attached to the Social Service Department would bring i t closer to the people of Vancouver and - 83 -help them become more interested i n what i s being done for those unable to support themselves. The 1955 Public Adminis-t r a t i o n Service Report on Vancouver noted that an advisory committee would be of service i n two main ways.1 F i r s t , i t could help the Department i t s e l f through the advice that com-mittee members might give from their own previous experiences and unique points of view. Secondly, the Department could benefit through the understanding and support which the ad-visors could channel back to their agencies and to the com-munity at large. The Report supported the formation of an advisory committee from a group of individuals or representatives of agencies most immediately affected by the s o c i a l service pro-gramme of the agency. The committee should not, however, be too parochial i n i t s membership; more than the social work profession should be represented i n i t . For example, health, employment, and education should be.represented as well as the public and ch i l d welfare f i e l d s . The c o l l e c t i v e opinion of such a body should be similar to a miniature p o l l of public opinion i f the members are representative of the various i n -terests i n the community.' At this time, the Vancouver Community Chest and Council i s reviewing the r e s p o n s i b i l i t i e s of public and private .1 Report, op.cit., p.120. - 84 -agencies. This i s an area that must precede any community action. Impediments to good working relationships between public and private agencies a r i s e most commonly i n relation to the divi s i o n of the welfare f i e l d . In every community that supports more than one organized agency, a clear-cut d i v i s i o n of the f i e l d should be arrived at. After arr i v i n g at a s a t i s -factory d i v i s i o n of the f i e l d , the private agencies should be prepared to make the major portion of the adjustments. The functions of public agencies are defined by law, hence they cannot usually make immediate changes i n programme. Most agencies, public or private, are reluctant to modify too sharply a programme that has been carried f o r years and has won sub-st a n t i a l respect i n the community. The City Social Service Department has a history of being a public assistance agency. It may well be that i t s functions should be broadened to include non-relief services. Some f e e l that i n the future the City's role i n welfare adminis-tra t i o n might be enlarged that Vancouver w i l l have a Department of Public Welfare.* This envisioned Department would include a div i s i o n of corrections having j u r i s d i c t i o n over the City J a i l , Juvenile Detention Home and probation within the City; a d i v i -sion of public assistance having the functions of the present Social Service Department; a di v i s i o n of c h i l d welfare respon-1. Professor W. G. DIXON, Acting.Director of ;the'Univer-s i t y of British;Columbia School I of Social Work, ;infa :Public Administration Seminar^ Ap r i l 1957* s i b l e f o r placing children for adoption, foster care and other duties presently carried out by the Children'•s Aid Societies; a d i v i s i o n of services to old people; a di v i s i o n f o r research into the community problems i n Vancouver; a special-projects d i v i s i o n to study, on a short term basis, the need for special services i n certain areas. This l a s t division, one would think, would work i n very close cooperation with the Vancouver Com-munity Chest and Council. The materialization of :the Department of Welfare i n Vancouver would leave the ;private agencies free t o ; u s e • i n i t i a -t i v e and invention i n carrying :out'imaginative•programmes for special'classes of persons needing help other than given by the public agency. This type of public agency development has been'carried to f r u i t i o n i n other areas: Edmonton, Alberta, for"example. The City Social Service Department would appear to have a good organizational set-up. The decentralization of the Department i n the 1 9 4 0 's paved the way and pioneered with t h i s method of administration for other social agencies i n Vancouver to'follow, iThe Department appears to be:administering i t s pro-gramme for those i n need i n an e f f i c i e n t manner f o r i t s c i t i z e n s . The personnel of the Department are, however, i t s outstanding quality. Many workers have had.the benefit of some university training i n social work although some of i t s best workers are - 86 -the product of s t a f f in-service training courses. It i s a sad thing, however, that the social caseworkers hired by the Depart-ment are unable to do the job they f e e l necessary to help t h e i r c l i e n t s due to large caseloads. A reduction i n the number of assistance recipients i n each caseload would give the workers more scope to work with and more persons might be helped to be again self-supporting. Because i t i s an assistance agency, i t i s l o g i c a l to think that more consideration would be given by the Department to the adequacy of the assistance given i n r e l a t i o n to the re-h a b i l i t a t i o n of recipients, especially families. The present 80-20 basis of sharing assistance costs between the Provincial Government and City of Vancouver should be seen as a base to b u i l d on rather than as a summit of benefits. The provincial government i n B r i t i s h Columbia supplements the Dominion's Old Age Assistance programme with a c o s t - o f - l i v i n g bonus. The l o c a l government, r e a l i z i n g the need for larger allowances i n the urban areas over the rural, would do well to supplement the allowance rates thought to be suitable for the province as a whole. The rates agreed upon by V i c t o r i a should be seen as a base upon which to build rather than as an end i n themselves. The 1955 Public Administration Survey of Vancouver administration recommended that•the Department assume;a more positive role of leadership i n the community that the causes of dependency might be i d e n t i f i e d and attacked.*" The writers of the Report were of the opinion that the City Social Service Department should act "as a c a t a l y t i c agent to bring together whatever resources, agencies, or forces i n the community may 2 be necessary to eradicate these causes". The studies mentioned i n Chapter I by Bradley Buell and Associates may well have i n -fluenced the authors of the Report. Buell f e l t that the public welfare agency should take leadership i n determining the causes of dependency and organize-the other welfare agencies i n the community to fight these causes. Vancouver does not appear ready for such a change i n i t s administrative thinking. It i s d i f f i c u l t to envision t h i s happening after the Department*'s .long period of neutrality on the welfare scene i n this community. I t seems that Vancouver would prefer some other agency than.its Social Service Depart-ment to? accept the role of leader. Coordination i s no less needed i n Vancouver, but the City i s not l i k e l y to accept this r e s p o n s i b i l i t y . It i s to the Community Chest and Council that those seeking leadership on a community basis must look. His-t o r i c a l l y , the amount of leadership that public welfare agencies have given the community has been small; Canadians have placed the private agencies i n this role. The philosophy of.public 1. Report, Public Administration Survey, op.cit., p.113. 2 . Ibid., p.,114. - 88 -welfare i n this country precludes those agencies organized to administer welfare l e g i s l a t i o n from branching out to develop new programmes. A great lack exists i n that almost no*research i s being carried out by the Department. Research i n the past, with the exception of Mr. Murray C. Colcleugh's study of the single male unemployed group during the winters of 1954 and 1955, has been carried out mainly by students at the University of B r i t i s h Columbia School of Social Work to obtain data f o r theses. Re-search might be done into the extent of the problem the Depart-ment is ;organized to:combat, the kinds of persons'on i t s r o l l s , and the degree of success i t has using the methods i t now u t i -l i z e s . Despite very heavy caseloads that l i m i t experimenta-tion, many public welfare agencies have succeeded i n obtaining appropriations for research and demonstration projects. It i s recommended that the City of Vancouver undertake a'pilot project into the problem of dependency i n Vancouver. Recently i n Canada a new type of agency has arisen. These agencies might be called quasi-public agencies as they are neither wholly public nor wholly private i n their type of administration. The Dominion Government, for example, gives money to lo c a l John Howard Societies who are responsible for - 8 9 -much of the after-care work being done with ex-inmates of correctional i n s t i t u t i o n s . The Provincial Government i n B r i t i s h Columbia gives money to the Alcoholism Foundation of the province. These agencies are largely supported with the aid of public funds although their board membership i s almost entirely composed of private c i t i z e n s . The City might profitably contribute money for a special project of combined public and private agency person-nel to demonstrate methods needed to help persons now depen-dent work toward r e h a b i l i t a t i o n . The f i r s t step would be to identify those persons having the best prognosis for rehabi-l i t a t i o n . The various agencies' workers with.these families i n their caseloads would be given the opportunity to do more intensive work with them, or several of these families might be grouped together i n a special caseload and be the respon-s i b i l i t y of one experienced worker. In this l a t t e r way, special small'caseloads would be established i n various 1 agencies and the cl i e n t s within them would be given every chance to grow, with the workers' help, to independence. Rather than having a number of workers from different agencies v i s i t i n g the same family, i f the City made money available to pay some of the administrative and service costs, the agency appearing to best suit the needs'of'the individual"family could'be " u t i l i z e d . Where i t appeared that more adequate f i n a n c i a l aid - 90 -was needed than provided for i n the maximum Social Assistance grant, the City might supplement i t ; i n this way the family members could devote their energies to solving the problems which lead them to become dependent. This type of r e h a b i l i -tation project would very probably show, as others have shown, that :adequate allowances are needed i f persons are to be helped to grow from dependency to a more natural way of l i v i n g . The p i l o t project should not be confined to social agencies as such, but should include police and correctional services, health services and recreation f a c i l i t i e s . Mental health services, too, should be included. Such concentration i s needed to show that i n this way only can the problem of de-pendency be fought i n an urban centre l i k e Vancouver. Vancouver has the resources; i t should use them to the best advantage. It i s only with a sharp focus using intensive casework and other services that the neurotic cycle of dependency can be broken. Study upon study has been carried out and a l l point to-tjie need for adequate diagnosis of those who can be helped followed by an intensive treatment period i f dependency i s to be chedked. Vancouver would do well to follow the.' example : set by other^cities and make a sincere attempt'to'help those who 1 can be'helped. The foregoing has described the social conditions pre-valent i n Vancouver at this time.::Long-range!programmes aimed at combatting dependency i n the future have been.outlined. Im-- 91 -mediate goals that might he worked toward by the Department i n i t s fight -bo decrease the incidence of dependent citizens follow. These sp e c i f i c recommendations, based on experience i n other areas, are adapted to the Vancouver situation, and might well be u t i l i g e d by the Department as aids i n combatting dependency. It has been shown that the roots of many of the t r a -d i t i o n a l l y accepted symptoms of social disorder l i e deep i n the same s o i l . The studies already mentioned i n Chapter I and those 1 2 of-the Gluecks 'and Healy and Bronner show that the family can be a basic asset o r . l i a b i l i t y i n the cause or cure of s o c i a l disorder. It i s generally recognized that the "key to preven-t i v e planning l i e s i n a family-focussed diagnosis and treatment plan".^ Research must be directed toward the t o t a l family as a functioning unit because the "residual dependency load results from constellations of d i s a b i l i t i e s , the net result of which i s 4 to ;destroy :the family'.s a b i l i t y to produce income". The family - t h a t "greatest of a l l social institutions':- i s once more being ca l l e d upon to play a most important rol e . Again and again i t has been found that much;behaviour disorder i s generated by un-satisfactory relationships. It i s in.the family that we learn how to l i v e i n the larger community of l a t e r l i f e . The family's 1. GLUECK, S. and E., Delinquents i n the Making; Harpers, lew York, 1952. 2. HEALY, W., --and BRONNER, A.'F.-, .' New; Lights •: on ' Delinquency and Its Treatment, Yale University Press, New Haven; 1936. 3. BUELL, B.,,"Preventing'and;Controlling Disordered.Behaviour", Mental Hygiene, vol.39? no.3, July 1955, P«373. 4. BUELL, Community.Planning:for Human Services, op.cit., p.413. - . - 92 -characteristics have an important hearing on the course of chronic disease,. handicaps and behaviour disorders. The City of Vancouver Social Service Department ap-pears to have made•a beginning to work toward achieving similar goals as outlined i n the Texas study; An outline'for a social diagnosis of cases has been i n the hands O f casework supervi-sors since early 1956, but i t i s not known to what extent i t i s being used. This outline includes such things as: (1) The basic underlying problem; (2) Other'problems which have a bearing on the basic d i f f i c u l t y ; ( 3 ) A'statement'.showing the worker's understanding of the 1persons involved in:the case including their strengths •' and weaknesses; (4) The correlation between the '• agency -structure and ' the 1 client-'s problem; (5^ A'.technical analysis of the worker's role i n the particular case; j (6) A general Iformulation'pointing to'diagnosis and needed itreatment. Too; a new"outline f o r i the guidance of workers'making the f i r s t home visit:to:assistance applicants, produced by a special•Recording;Committee composed of>agency social workers, has • a.: section for the v i s i t o r ' s diagnostic .assessment' of the c l i e n t . Caseloads must be decreased 1 i n size*-.however, i f - 93 -workers are to spend s u f f i c i e n t time to arrive at a meaningful diagnosis of each case. U n t i l the size of caseloads are decreased i n number, workers w i l l be unable to give the necessary time to determining which c l i e n t s need only f i n a n c i a l aid and which need continued casework services also. Medical and f i n a n c i a l aid i s needed by a l l recipients but, alone, they are not enough to ade-quately meet the needs of a l l c l i e n t s . The City of Vancouver so c i a l workers have the respon-s i b i l i t y to help many persons released from tuberculosis sani-t o r i a become again, self-supporting. Due to the sige of the caseloads, however, workers may f i n d i t impossible to give these persons the attention that they need i f they are to become re-habilitated. One way i n which caseloads might be reduced i n number would result from the City showing the need f o r more adequate;work being done by the Division of Tuberculosis Control of:the provincial government. It has been shown that the City Social Service Depart-ment makes available to needy persons a wide range of f i n a n c i a l , medical and social services. This programme i s based on the good l e g i s l a t i v e structure outlined i n the f i r s t chapter of this study. The Department, the author feels, emphasizes the giving of meet;the physical needs of i t s c l i e n t s . 'One of the characteristics of the Department i s i t s emphasis on economy. Economy i n programme, for example, i s - 9 4 -evidenced by the fact that Vancouver does not permit the exemptions of allowable assets to the amount permitted by the Social Assistance Act. 1 The Act allows $ 2 5 0 . 0 0 value f o r per-sonal property i n addition to necessary household equipment and wearing apparel i n the case of a single applicant without de-pendents and $500.00 for married persons with dependents. But the City usually permits only $150.00 for applicants without dependents and $ 3 0 0 . 0 0 cash reserve for persons with dependents. It should be stated that assistance i s not refused on this basis alone, however, i n Vancouver. At the beginning of February 1957 j a statement by the Vancouver Community Chest and Council was given much publ i c i t y i n the press. This statement announced that the Chest was no longer w i l l i n g to buy shoes for school children i n need. Of the over one thousand school children provided with new shoes or shoe repair service i n the year preceding the announcement of discontinuance, i t was estimated that over 70 per cent were members of families i n receipt of Social Assistance. Although at f i r s t glance i t appeared that the discussions which followed this announcement centred around the question of who should pay for shoes for school children i n need, this was not the basic problem. The City Social Service Department did not look favor-ably on the idea of a return to giving assistance i n kind. The 1. The Social Assistance Act i s followed i n a l l parts of B r i t i s h Columbia except Vancouver which accepts re s p o n s i b i l i t y f o r i t s needy persons from the Vancouver Charter. - 95 -Department preferred to press for higher allowances f o r those families with dependent children rather than sponsor a programme to give out pairs of shoes through the schools to those i n need. Rather than the di v i s i o n of responsibility being the focal point of discussions, i t was the philosophy of giving assistance i n kind on which the City administration could not agree with the Community Chest. The Provincial Government has an important part to play i n the determination of the amounts of money and degrees of service that w i l l be made available to recipients of Social Assistance. The City administration i s closer to those i n need and so should be better able to press for an improved programme for i t s needy persons. Any public agency programme must appreciate the exis-tence of two overlapping duties: to the c l i e n t and to the tax-payer who supports the programme. Trouble arises when one of these duties i s permitted to overshadow the other i n such a way as to be detrimental to i t . The short-range view of saving the all-important tax-payers' dollars may lead to economy this year and the next with the person continuing to be a c l i e n t f o r the th i r d year. Vancouver's accent on economy would appear to be a rather shortsighted policy. One way i n which economy might better be achieved i n the administration of the Department would be by changing i t s approach from a l l e v i a t i o n only to prevention plus a l l e v i a t i o n . Action should be taken to strengthen the pro-gramme of the Department to lead i t toward the objective of pre-vention at the same time as adequate services are given to those already dependent persons i n receipt of assistance. The fact that the majority of the members of any "hard-core" group existing i n Vancouver w i l l be recipients of s o c i a l assistance, places the City Social Service Department i n a unique position. As the provider f o r the indigent of the community, the public welfare agency has the a b i l i t y to become the major source for data on family needs for the t o t a l community. Many of the problems present i n public assistance families might have been solved e a r l i e r i f the t o t a l community and i t s organized services had been more available at an e a r l i e r period. When other s o c i a l agencies i n the community f a i l to help a l l those who come asking for aid, the public welfare agency must bear the brunt of the r e s u l t . Social assistance has become a residual programme for those unable to meet the requirements for other welfare pro-grammes; i t i s the only means l e f t to help those who must other-wise "go on the street". To expect the City to take f u l l r e s p o nsibility for any such group of persons would be rather optimistic, but the City should take an active part i n a drive to determine the roles the various agencies might play i n combatting dependency i n the com-munity. For too long the Department has been concerned only with the problem of dependency after i t has arisen. Adequate help i n solving the social problems i n the community depends on the degree to which the various agencies assume responsibility and support one another. Community organization i s one of the basic professional r e s p o n s i b i l i t i e s of every social agency. The agency administration should not devote so much time to the actual operation of i t s programme that l i t t l e or no time remains for community organization. The to t a l obligation of any agency i s not discharged unless this aspect of i t s work i s recognized and cultivated f o r the good of the community. Vested interests and pride of autonomy must take a position of minor importance fo r agency administrators i f they are to accept an opportunity to embark on a reasonable plan to achieve a goal of prevention and reduction of serious community problems. Vancouver must achieve a position where i t s many agencies p u l l together to attain a common goal rather than "ri d i n g off i n a l l directions" without overall leadership and guidance. Like many other c i t i e s , Vancouver has i n the past given more thought to the development of new agencies, organi-zations, foundations and the l i k e rather than assessing the various areas of competence of the existing resources within the community. This has led to an overlapping of services by a combination of agencies under various auspices. The f i r s t step i n any plan f o r change i s agreement by those who hold the purse strings. For this reason the general public must be made more aware of the demoralizing effect that results from having to l i v e on an inadequate Social Assistance grant. Those who do not know the facts should not be blamed for their apathy toward the plight of these people. Facts, given i n an objective, truthful way are needed to promote feelings i n the public to induce them to wish for a change. More workers cannot be hired as a means of lessening the size of caseloads u n t i l the public i s appreciative of the value of such a move as a means to combat continued dependency on the part of those already on assistance. Research cannot be requested into the causes and cures of dependency u n t i l the public i s aware that such know-ledge i s needed. Community-wide organization w i l l not be de-manded u n t i l the public i s shown the need for i t . In the humanitarian professions, no matter how high the quality of the therapy given, i t cannot function i n a com-munity vacuum. For too long, the Vancouver public welfare agency has been isolated from the ordinary man and i t i s now suffering from lack of public support. The writer's observations lead him to believe that the ordinary man knows almost nothing about how the more than two dollars i s spent for every man, woman and c h i l d i n Vancouver by the Social Service Department* The people 1. Rough figures indicate that ,• the • Department has a budget of $1,000,000 and the City a'population tffi*400,000. - 99 -of Vancouver have a right to know the nature of the task that i t s welfare department handles. A l l citizens have the right to know 6f the types of persons who must ask for f i n a n c i a l aid and how they fare with i t . ; I t i s only with an educated populace that needed changes are brought about. Vancouver's apparent apathy regard-ing things not d i r e c t l y related to the individual c i t i g e n can be combatted only by a strengthened movement, to educate. The City administration has welcomed feature writers of the Vancouver newspapers to come in , examine and write about the work of the Department. In this way the citigens have learned of some of the conditions under which assistance recipients l i v e . A public-service radio programme "The Bridge Between" also devoted one of i t s programmes to the work of the Department. More needs to be done, however, as the whole story has never been to l d . The Department, the author feels, i s not only misunderstood by the private citizens of Vancouver, but also by the other s o c i a l agen-cies. Part of this misunderstanding must remain as a result of the unhappy Depression experience and the h o s t i l i t y l e v e l l e d at the Department at that time so that a public relations programme now must combat this negative public feeling toward the Depart-ment as well as the apathy of the c i t i z e n s . The writer i s of the opinion that i t i s a great pity that the people of Vancouver do not r e a l l y know of the excellent work this Department does. - 100 -In conclusion, the following points should he repeated f o r emphasis: (1) The problem of dependency can be fought most ef-fe c t i v e l y on two fronts: (i) community-wide action i s needed with a l l the health and welfare agencies pulling together f o r a common goal. This must be preceded by each agency r e a l i z i n g i t s own f i e l d of competence and f i t t i n g i t into the to t a l com-munity picture; ( i i ) individual agencies must be prepared to give intensive treatment to those diagnosed as being most l i k e l y to benefit from i t and grow from th e i r dependent state. Small caseloads must be u t i l i z e d to effect t h i s . (2) Public welfare programmes must have public support. An educated populace i s needed for a programme to be modified i n a way to enable i t to keep abreast with modern concepts regarding the a l l e v i a t i o n of dependency. Advisory committees have been found to be' most useful devices to promote c i t i z e n interest i n the ;public welfare department. (3) Despite heavy caseloads, many public welfare agen-cies have made p i l o t projects to determine how best to help the assistance recipient become rehabilitated. A quasi-public agency sponsored by the City of Vancouver might carry out a similar project i n Vancouver. - 101 -APPENDIX A BIBLIOGRAPHY (a) G eneral References ALTMEYER, A. J . BOWERS, S., BOYDEN, ''E. P., BURNETT,' M. C f, CASSIDY,' H. M., COHEN, N. E., FRENCH, D., "Issues F a c i n g S o c i a l W e l f a r e Today", S o c i a l , Work J o u r n a l ; vol.33, n o . l , 1952. "The Nature'and D e f i n i t i o n o f S o c i a l Casework", j o u r n a l of S o c i a l Casework, isol.30, nol8, October 1949. • " S h a l l We Have a W i t c h Hunt?", H i g h l i g h t s , vol.12, no.10, December 1951. "The R o l e of the S o c i a l Worker i n Agency-Community R e l a t i o n s h i p s " , P r o c e e d i n g s , N a t i o n a l Conference o f S o c i a l Workers, Columbia U n i v e r -s i t y P r e s s , New York, 19 . S o c i a l S e c u r i t y and R e c o n s t r u c t i o n i n Canada", Ryerson, Toronto, 1943. " P r o f e s s i o n a l S o c i a l Work Faces the FutuBe", S o c i a l Work J o u r n a l , vol.36, no.3, J u l y 1955* Measuring R e s u l t s i n S i b c i a l Work. Guide t o ' t h e S o c i a l S e r v i c e s , F a m i l y Welfare fissociation, London, England, 1955. HAMILTON, G., HAWKINS, G., KING, C , McMILLEN, _W., MARCUSE, B., Theory and P r a c t i c e of S o c i a l Casework, Colum-b i a U n i v e r s i t y P r e s s , New York, 1954. E d u c a t i o n f o r S o c i a l U n d e r s t a n d i n g , American A s s o c i a t i o n f o r A d u l t E d u c a t i o n , New York, 1940 O r g a n i z i n g f o r Community A c t i o n , Harpers", New York, 1948. Community O r g a n i z a t i o n f o r S o c i a l W e l f a r e , U n i v e r s i t y of Chicago, 1947. Long-term Dependency and Maladjustment Cases, Master o f S o c i a l Work T h e s i s , U n i v e r s i t y o f B r i t i s h Columbia, 1956". R e v i s e d S t a t u t e s of B r i t i s h Columbia, Chapters 232,246,310. SAMUELSON, Economics, M c G r a w - H i l l , New York, 1951. TOWLE, C. Common Human Needs, American A s s o c i a t i o n of TOWLE, C. S o c i a l Workers, New York, 1953. " F a c t o r s I n Treatment", P r o c e e d i n g s , N a t i o n a l Conference o f - S o c i a l Workers, 1936. -. 102 -WHITE, R. C. Administration of Public Welfare, American Book Company, New York, 1950. (b) Specific References "Is There a Legal Right to Assistance?", Social Service Review, vol.12, no.2. "Some Facts about Public Welfare Today", Highlights, vol.13, no.l, January 1952. American Public Welfare Association, Adequate Staff Brings Economy, Chicago, 1939« ABBOTT, E., ALTMEYER, A. J., BERGER, M. A., BRUNOT, J., BUELL, B., "Emotional Problems of Dependency", Public  Welfare, vol.11, no.4, A p r i l 1953. "The Board Member i n a Public Agency", Proceedings, National Conference of Social Workers, Columbia University Press, New York, 1941. "Preventing and Controlling Disordered Behaviour", Mental Hygiene, vol.39, no.3, • July 1955. City of Vancouver, Financial and Departmental Reports, f o r the years ending December 31, 1929-1955* CURRIN, M., de SCHWEINITZ, K. FALK, I. S., HERZj J•j HILLIARD, R. M., H00S0N , - w . , MARGOLIS, H. MARTZ, H. E., M., "Operation Diagnosis - Providing Casework i n Large Caseloads", Public Welfare, vol.12, no.4, October.1954. "Social Work i n the Public Services", Social  Work Journal, vol.36, no.7, July 1955-"Reduction of Dependency through Health Programs", Public Welfare, vol.7, no.5, May 1949. "Tuberculosis and Personality Conflicts", Psychosomatic Medicine, June 1944. "Attacking Dependency at Its Source", Public Welfare, vol.6, no.2, February 1948. The Rehabilitation of Public Assistance  Recipients, Master of Social Work Thesis, University of B r i t i s h Columbia, 1953. "Care of the Patient with Rheumatoid A r t h r i -t i s " , The Family; vol.25, nol9, January 1945< "The Contribution of Social Work to the Ad-ministration of Public Assistance"; iSocial  Casework, vol.37, no.2, February 195.6. - 103 -MINTON, E., "The Effect of Setting on Casework Practice i n Public Assistance", Social Casework, v o l . 3 7 , no.2, February 1956. PERLMAN, H. H., "Casework Services i n Public Welfare", Proceedings, National Conference of Social Workers, 1947. Public Administration Service, Report on the Administration of of the City of Vancouver, 1955* SCHLEISS, B. G., SMITH, A. D. WILTSE, K. T., WITTKOWER, E., WRIGHT, H. R. "Social Casework Services to the A r t h r i t i c Patient", The Family, v o l . 2 5 , no.9, Janu-ary 1945-"Community Prerogative and the Individual", Proceedings, National Clnference of Social Workers, 1946. Social Casework i n Public Assistance, C a l i -fornia State Department of Social Welfare, Sacramento, 1952. A Psychiatrist Looks at Tuberculosis, The National Association for the Prevention of Tuberculosis, London, 1949• "Dependency", Encyclopedia of the Social  Sciences, Macmillan, New York, 1950. 40 - 104 -Table 6 . Numbers on Social Assistance by cases and individuals  for the years 1951-1955 Month _ 1 9 5 i . . Cases Indiv 1952 Cases Indiv 1953 Cas es Indiv 1954 Cases Indiv 1955 Cases Indiv Jan 4153 5328 4094 5296 2953 4004 2998 4127 4503 6238 Feb 4069 5326 3425 4683 3015 4146 3053 4185 4501 6115 Mar 4070 5273 3076 4289 2982 4114 3619 4973 4575 6279 Apr 4095 5337 3002 4089 3002 4117 3793 5252 4742 6478 May 4038 5225 2924 4068 2974 4079 3247 4674 4882 6657 Jne 3983 5188 2828 3908 2928 3975 3336 4668 4457 6268 J i y 3919 5100 2860 3924 2860 3875 3383 4681 4118 570 6 Aug 3925 5084 2843 3935 2806 3798 3289 465? 3323 4827 Sep 3870 4978 2831 3875 27 61 3760 3272 4628 3191 4581 Oct 3886 4997 2776 3787 2773 3744 3316 4679 3077 4408 Nov 3949 5069 2802 3790 2847 3875 3434 4849 3123 4506 Dec 3998 5144 2879 3874 296O 4093 3936 5505 3183 4491 Individual Average" 5179 4126 3965 4739 5546 Vancouver Population Per cent 385,500 1.343 • 390,325 I.050 393,325 I.007 393,500 1.221 399,727 1.387 Source: City of Vancouver Social Service Department monthly st a t -i s t i c s for January 1951 to December 1955' Population figures are from the Vancouver Municipal Year Book.Qoompiled' by the City Clerk 1956, page 64. - 105 -Table 7. Social Service Expenditures in Relation to the  Total Expenditures in Vancouver 1929-1955 Total Social Service Percentage of Year Expenditures Total Expenditures 1955 $ 979,829 2.67 1954 935,703 2.38 1953 914,668 2.60 1952 910,893 2.75 1951 921,821 2.94 1950 767,912 2.81 1949 664,948 2.61 1948 486,133 2.21 1947 365,052 1.86 1946 355,587 2.05 1945 311,427 1.97 1944 282,541 I . 8 4 1943 277,977 1.88 1942 319,280 2.21 1941 487,323 3.42 1940 691,665 4.89 1939 843,813 5.93 1938 1,007,871 7.10 1937 814,308 5.84 1936 882,452 6.42 1935 1,182,044 8.31 1934 1,425,944 18.29 1933 1,431,130 19.00 1932 1,206,578 12.39 1931 736,283 7.14 1930 . 565,448 5.6O 1929 375,321 . 3.76 Source: Corporation of the City of Vancouver Financial  and Departmental Reports for the years ending December 31, 1929-1955. - 106 -Table 8. Composition of Social Service Department Expenditures 1929-1942 Admini- General Unemploy- Old Kamlc Year strative Relief ment Relief Peoples' 1 Home Costs Home 1942 119,787 22,529 304,755 14,169 355 1941 163,244 51,750 257,755 14,452 119 1940 196,649 162,561 676,626 14,876 161 1939 197,987 201,034 430,787 13,701 304 1938 192,460 358,876 442,844 13,309 382 1937 165,822 211,025 423,201 13,629 631 1936 169,453 197,065 500,536 14,647 750 1935 171,648 132,639 863,167 13,431 1,160 1934 190,145 156,319 743,536 10,307 1,296 1933 203,430 189,893 672,777 10,954 1,364 1932 55,341 274,801 555,853 10,574 2,254 1931 91,596 311,240 300,293 12,895 2,641 1930 51,588 271,975 296,590 15,400 2,454 1929 58,278 185,799 87,008 17,841 1,449 Source: City of Vancouver Financial and Departmental Reports for the years ending December 31, 1929-1942. The "Administrative Costs" column does not include the staff supplied by the Provincial Government. "General Relief" represents the City of Vancouver proportion only; the Provincial Government adds to this. The "Unemplyment Relief" figure for 1932, includes 75 per cent of the administration costs of the entire Relief Committee. The 1930 and 1931 figure in this column includes 40 per cent of the administrative costs of the Relief Committee. The City of Vancouver operated a creche from January u n t i l June i n 1932, and subsidized the Vancouver Day Nursery at a total cost of $6,069. Creche costs for 1929, 1930 and 1931 were $12,476, $13,470 and $8,809 respectively. - 107 -Table 9. Composition of Social Service Expenditures 1943-1955 Year Admi ni s t r at i v e Social Taylor Kamloops Costs Assistance Manor Home 1955 293,976 658,118 27,735 -1954 325,632 602,082 28,565 -1953 301,811 585,206 27,650 -1952 289,242 592,870 27,917 864 1951 270,137 615,109 25,388 678 1950 246,089 493,744 24,155 426 1949 240,110 399,435 25,234 169 1948 176,993 286,907 21,747 485 1947 138,254 208,853 16,309 1,636 1946 125,975 211,215 17,492 904 1945 107,343 189,627 14,060 397 1944 98,178 168,597 15,392 374 1943 99,223 163,165 15,203 387 Source: Corporation of the City of Vancouver Financial and  Departmental Reports for the years ending December 31, 1943 to 1955. Administrative costs do not include the s t a f f supplied by the Provincial Government. Social Assistance costs rep-resent the City of Vancouver proportion only; the Prov-i n c i a l Government adds to t h i s . - 108 -Table 10. Reasons given by persons applying for assistance i n two caseloads Reason Alcoholism Arterioscerosis A r t h r i t i s Asthma and eczema Blindness Cancer Cerebral hemorrhage Cerebral thrombosis Diabetes Epilepsy Gas t r o-i nt e s t i nal G' e ni t o-uri nary Goitre and thyroid Heart condition Hypertension Mental condition Multiple sclerosis Paralysis Physical injury Respiratory Post-polio Tuberculosis Varicose veins Women with depend-ent children Awaiting OAA or OAS Unemployed employable 4 1 Caseload "A" men women 3 3 16 6 1 2 1 1 1 3 3 1 8 5 7 2 12 1 3 18 3 6 1 4 1 3 1 Caseload "B" men women 1 3 4 1 3 1 3 1 2 5 1 8 2 2 1 2 1 1 5 13 2 Totals 106 20 13 52 - 109 -Table 11. S t a t i s t i c s concerning two caseloads during February 1957 (a) Year of opening cases Caseload "A" Caseload "B" ear men women men women 1957 11 - 1 8 1956 16 2 - 13 1953-55 41 7 7 25 1951-52 18 2 1 2 1945-50 18 6 4 4 1940-44 2 1 - -1930-39 - 2 - -Totals 106 20 13 52 (b) Year of b i r t h of cli e n t s Year Caseload "A" Caseload "B" men women men women 1936 to date - - - -1921-1936 6 1 l 10 1911-1920 6 5 3 9 1902-1910 23 5 3 18 1896-1901 30 5 3 5 1891-1895 31 4 2 8 Before I89O 10 - 1 1 Totals 106 20 13 52 -110-Table 12. Age and c l a s s i f i c a t i o n of persons askagg aid from ember 1956 and January 1957 Agency 20-29 Age 30-39 40-49 50-59 Central City Mission 39(18) 47(22) 44(20) 22(10) F i r s t United Church 107(14) 189(25) 193(25) 170(22/ Holy R"bsary Cathedral 110(24) 142(32) 109(24) 47(10) John Howard Society 65(35) 59(32) 28(15) 11(6) Salvation Army 215(22) 298(31) 217(23) 136(14) Sisters of Atonement 18(11) 22(13) 38(23) 47(28) Averages (21) (26) (21) (15) Agency 1' C l a s s i f i c a t i o n 2 3 , 4 Unci. Central City Mission 76(35) 35(15) 2(1) 3(D 101(47) F i r s t United Church 434(^7) 76(10) 96(13) 147(19) - -Holy Rosary Cathedral 114(25) 130(29) 15(3) 126(28) 62(14) John Howard Society 120(65) 49(27) 8(4) 6(3) - -Salvation Army 678(71) 170(18) 8(1) 2C2) 100(10) Averages (51) (20) (4) (10) (15) Note. A l l numbers i n parentheses are percentages. The Sisters of Atonement did not c l a s s i f y 77 per cent of those going to them for aid. Source. Both tables were composed from unpublished findings of the Community Chest and Council survey of the extent of the problem of the unemployed employable group i n Vancouver during December 1956 and January 1957* \ - I l l -APPENDIX C SETTING IH WHICH THE PERSONS LIVE IN THE TWO CASELOADS STUDIED.  (i) Caseload "A" Persons i n Caseload "A" a l l l i v e on the fringe of Vancouver's main skid-row area. These people l i v e i n very poor physical surroundings and as a rule dwell i n single rooms which are small, dark, and d i r t y . Rooms are generally rented for between $20. and $30. per month, including l i g h t and heat. Dhinese persons i n this area appear to manage better than Occidentals. They usually l i v e i n clan houses or "Tongs" where their rents are low; the fraternal atmosphere allows for a more natural way of l i f e . Many of the older Chinese citizens s t i l l follow the 'old way' and eat simple, cheap meals cooked i n a communal kitchen. The area this caseload covers i s a compact section of the c i t y ; i t i s 4 blocks long and 3 blocks wide. It con-tains what i s probably the greatest number, on a per capita basis, of persons receiving assistance than any other section of the City of Vancouver. - 112 -( i i ) Caseload "B" Similarly to Caseload "A", a l l persons included i n this group l i v e i n the same geographical area. Because the incidence of social assistance recipients i s lower i n this part of the City, the area covered i s larger. There are many large old wooden houses hut new apartment buildings interspersed among them give a brighter note to the streets. The majority of the large old homes have been re-conditioned to make accommodation for "roomers" of single and married persons. This area i s at present slowly undergoing transition from one family to multiple family dwellings. Although many of them have been changed to accommodate other persons, some of the old homes are s t i l l maintained by one family. The l a t t e r are usually kept i n better repair than those which have been renovated. Rents may range from $15* for a single basement room in'quite good repair to $60. for an apartment or older home suitable f o r a family. Some small manufacturers and wholesalers have buildings i n this area and there are many corner stores to serve the d i s t r i c t . - 113 -APPENDIX D Distribution of Vancouver's Social Welfare ; Costs.  The financing arrangements for meeting Vancouver's social welfare needs f a l l into three categories: some services are financed entirely by the City, some by the Province, and ' some are shared on an 80-20 per eent basis by the Province and 6ity. (l) Entire costs accepted by the City of Vancouver: In this category are included costs above the scale l a i d down by the Province f o r social assistance, boarding and nursing home cases. Any money requested for extra rent i s the responsibility of the City as are burial charges and coroners' enquiries. Taxis and ambulances for assistance recipients having residence i n Vancouver and children's clothing are met entirely by the City. ( i i ) Entire costs accepted by the Province: Costs incurred by present residents i n Vancouver who have their previous residence established as i n unorganized t e r r i t o r y i n B r i t i s h - Columbia are exclusively the responsibility of the Province. Included i n this are transportation and bu r i a l charges as !well as coroners' enquiries. In Vancouver, Mothers' Allowance recipients are v i s i t e d by the City's social workers although.all money for their support comes from the Department - 114 -of Health and Welfare. The City adrainistBrs Mothers' Allow-ances and reports a l l findings to V i c t o r i a of changes i n c i r -cumstances. ( i i i ) Cists shared by the Province and City: (a) Expenses incurred by persons who are i n receipt of Social Assistance and who have established residence i n the City. Financial help i s shared on an 80-20 per cent basis to the maximum amount as l a i d down by the Province. I f the City were to pay more than these amounts to i t s c l i e n t s , i t would be entirely responsible for the additional expense with no further help from the Province. (b) Boarding home care to the maximum of $65.00 per month and nursing home care up to $5*00 per day. (c) Extra comforts allowances for special cases up to $7.00 per month and supplementary allowances to $5.00 less than the boarding home rate of $65.00 per month. (d) Extra allowances.for post-tubercular cases as re-ferred from'the Social Service Department of the Tuberculosis Division of the Provincial Health Department; this does not i n -clude transportation, however, to and from c l i n i c s . (e) Medical extras for those people having certain types of ill n e s s e s and who may need special diets as a part of treatment. ( f ) Dentures. (g) Housekeeper and homemaker s e r v i c e s . (h) Expenses i n c u r r e d i n o p e r a t i n g T a y l o r Manor. ( i ) I n t e r m u n i c i p a l accounts d e a l i n g w i t h persons i n r e c e i p t of A s s i s t a n c e i n o t h e r m u n i c i p a l i t i e s hut who have e s t a b l i s h e d r e s i d e n c e i n Vancouver. ( j ) Courses f o r the r e h a b i l i t a t i o n of A s s i s t a n c e r e c i p i e n t s . 1. Other medical s e r v i c e s , and drugs and g l a s s e s are shared by the P r o v i n c e and C i t y on a per c a p i t a b a s i s r a t h e r t h an the u s u a l .80-20 per cent s h a r i n g . 


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