From the Governor and Report

HOUSE No. 2137

Message from the Governor and Report

Reorganization of Boards and Commissions

HAVING SUPERVISION AND CONTROL OF STATE INSTITUTIONS.

Submitted by COMMISSION ON ECONOMY AND EFFICIENCY.

February 7, 1914.

BOSTON; WRIGHT & POTTER PRINTING CO., STATE PRINTERS, 32 BERNE STREET. 1914.

Cfte CommonUiealtJ) of Qiassadnisetts.

MESSAGE FROM THE GOVERNOR RELATIVE TO THE REORGANIZATION OF CERTAIN STATE DEPART- MENTS AND TO PROVIDING FOR A CENTRAL BOARD OF CONTROL, AND TRANSMITTING A PLAN FOR THE SAME PREPARED BY THE COMMISSION ON- ECONOMY AND EFFICIENCY.

The Commonwealth of Massachusetts, Executive Department, Boston, Feb. 11, 1914 To the Honorable Senate and House of Representatives In my inaugural address to your honorable bodies, I recommended that “there be established a central purchasing agency for all the state departments and institutions, and that careful study be given to plans for reorganization under a central administrative body, a method of administration which has been adopted with marked success in several states with great saving to the public treasury.” I now have the honor to transmit to you a plan for the reorganization of certain state departments providing for a central board of control which has been prepared by the Commission on Economy and Efficiency, and which, in its essential particulars, meets the recommendation made in my inaugural. The report of this commission is entitled to your most careful consideration. It comes to you from that department of the state government which has been especially entrusted by the legislature with the duties and respon- sibilities of advising you on this particular problem and after study and investigation of state institutions covering a period of several months. Chapter 719 of the Acts of 1912, creating the commission on economy and efficiency, defined among its other duties the following: “To inquire into the laws governing the financial transactions of the commonwealth and to study into the possibility of promoting greater economy and efficiency and utility in the transaction of the business of the commonwealth by any changes in such laws by the 1\ GOVERNOR’S MESSAGE [Feb.

reorganization, consolidation or co-ordination of departments and

institutions, by different methods of administration” ... “by

organizing a central purchasing agency or department,” . . . “and it shall report thereon from time to time to the governor and council and to the general court, if it is in session. In the report herewith submitted, the commission finds after thorough investigation, that our present system of managing the institutions of the state is faulty and leads to waste and unnecessary expense, and recommends in the interest of economy and efficiency a complete reorganization of all the state activities in dealing with its institutions should be undertaken. The sole issue presented to the legislature, therefore, is this; Is it in the interest of a better and more economical management, and that means, is it in the interest of the taxpayers of the commonwealth, that a change from the separate independent management of our state institutions should be made and in its stead a new system established providing for a central board of control? The importance of this subject can be better realized by a consideration of the following statistics; The number of members of boards, commissions and trustees which the report deals with and which this problem concerns is follow;

Board of Insanity o Board of Charity 9 Prison Commission 5 Trustees under Board Insanity 89 Trustees under Board Charity 28

136

Number of inmates of institutions affected 22,120 Number of employees 4,537 Investment of state money to date in all these institutions . $24,453,016.59

These various departments and state institutions are now asking for an appropriation of $7,040,800, for maintenance during the year 1914. Assuming the members of the commission to be honest and free from partisan bias or misdirected prejudice against the present management of these institutions, this report ought to make out a 1914.] HOUSE No. 2137. V prima facie case in favor of the adoption of the recommendations made. I do not undertake to point out to you in detail what reorganization plan should be finally agreed upon for before that question is reached there is a greater one which you must pass upon, namely, whether or not the state should depart from its present policy to that of a central board of control. When that is settled, I can foresee no serious differences as to details, and I have confidence that this legislature with the aid of the report before it will work out the necessary legislation along safe lines. If there is any field in the public service for the application of the principles of economy and efficiency here certainly is one, for the maintenance of our state institutions is the heaviest of all demands upon the public treasury; and we should see to it that there is such organization that the various managers, officers and employees shall at all times direct their work with a view to the strictest economy. By a consolidation such as is recommended, our state institutions would become inter-related; their industrial activities could serve each other; a specialization of their industries incident to their penal and correctional functions could be introduced with economy and efficiency and the whole be managed and directed upon a general basis and policy. While the legislature is giving its attention to these recommendations, pending demands for development of state institutions calling for large appropriations of money for building and equipment should be held in abeyance. Finally, I urge upon the legislature, which has in a most com- mendable way shown a determination to keep down to the very lowest point possible all new demands upon the state treasury, that it manifest the same spirit in weighing the recommendations made by this commission with a view to finding out whether or not a large saving may not be made in expenditures and more efficient management provided through a reorganization along the lines proposed of all the state agencies dealing with charitable, health and correctional problems. There is a widespread demand that public officials proceed cautiously with public expense that there may be prevented a revolt against the excessive burdens of government.

DAVID I. WALSH.

CONTENTS

PAGE Plan I. Centralized control under supervision of commissioners, but vestedjin or

director ...... 5 Commission on Public Institution, Powers and Duties Director of Institutions Executive Secretaries Division of work among executive secretarie Executive Secretary for Insane Executive Secretary for Hospitals and Sanatoria. Executive Secretary for Prisons and Correctional Institutions 9 Secretary Charity Executive for ..... 9 Business Agent 9 Unpaid Board of Three Visitors for Each Institution 10 Plan i 11. Supervision and Control by Board .f Co:•mmissioners 10

Fact :ors to be Considered .... 11 Orgaanization within Institution; 12 Prei sent Conditions Considered 17 Cases of Divided Authority in Supervi; •n •f State Institutions 17 State Infirmary 18 State Farm 18 Massachusetts Training Schc 18 Norfolk State Hospital . 19 Insane Hospitals and Asylums 19 Cross-Purposes in Functions and Activit 19 Development of Present Methods 21 Work Within the Institutions 9.9 Superintendents Other Official; 23 Employees 25

Som< Results of Present Methods 28 Accountir 29 Farm Managers Building Constn 33 The Immediate Xeec 51

Sit? (Umnnumunmltlj of ifaaadtusrtta.

February 9, 1914

To His Excellencij the Governor, State House, Boston, Ma . Dear Sir:—In its annual report for the year 1913, the Com- mission on Economy and Efficiency stated that it would recommend, in detail, such a reorganization of the different state boards having to do with the care of the various wards of the state and having control of the institutions for the care of insane, defective, delinquent and dependent persons, as would center the administrative work for all such institutions entirely in the hands of one central organization. In pursuance of that plan two outlines of organization for such a single department are presented to the legislature for consideration. To carry out its recommendations the Commission on Economy and Efficiency submits drafts of bills for the consideration of the legislature. The recommendation of the commission provides for organization on either of the following two lines: 1. A centralized control under a board of five commissioners, em powered to vest in one director the duties of administration. 2. A supervision and actual control by a board of five commissioners, to give all their time to the duties of their offices, and to be chosen with particular reference to the several different problems involved, from an administrative and correctional standpoint.

Plan I. A CENTRALIZED CONTROL UNDER A BOARD OF FIVE COMMISSIONERS EMPOWERED TO VEST IN ONE DIRECTOR THE DUTIES OF ADMINISTRATION.

COMMISSION ON PUBLIC INSTITUTION Five members, citizens of the Commonwealth, to be appointed by governor and council; chairman, to be designated by the governor for a term of five years, one member for term of 4 vears, one member 6 BOARDS AND COMMISSIONS, [Feb, for term of 3 years, one for term of 2 years, and one for term of 1 year, and thereafter the chairman and each member to be designated for the full term of 5 years. Each to receive an annual salary of $1,000.00, and to devote such time to the work as may be necessary. To be reimbursed for necessary travelling expenses.

Powers and Dutie (1) Their principal function should be to formulate the general policies and plans for the entire work of the new organization. Their responsibility for administrative duties should be direct, but they should be authorized to place such responsibility entirely upon the director whom they would choose and the executive secretaries whom they would approve. (2) Duty to make annual report to the governor and council, and to the legislature, describing conditions in department and institutions under its control and supervision, and making such recommendations for legislation as appear desirable. (3) Appoint the director, subject to confirmation by the governor, with removal under same conditions. (4) Confirm appointments of executive secretaries and business agent made by the director. In general, the commission on public institutions should be concerned with questions of policy. It should be the agency for in- suring that the large questions of care receive proper consideration, and that proper policies or plans of work and action are being carried out by the director and his associates. It should provide for such administration at each and every institution under its control, so that the medical administration may be separate and distinct from the business administration.

DIRECTOR OF INSTITUTIONS. Appointed for indefinite term by commission on public institutions, subject to approval by governor. Salary to be determined and removal to be effected in same manner. Under the control of the commission, to have direction over department and institutions, including all matters involved in their administration, operation and maintenance, whether pertaining to care, treatment and custody of patients, inmates and prisoners, or pertaining to business affairs of department and institutions; provided, 1914.] HOUSE —No. 2137 1 however, that no buildings or works shall be constructed or materially altered, no general classification of inmates of institutions shall be made, no requests for appropriations shall be submitted, and no general policies shall be adopted by the director until such matters have been submitted to the board of commissioners for their consideration and approval. Full responsibility to the commission on public institutions, governor and council, and legislature for proper administration of department and institutions. Authority to appoint executive secretaries, business agent and superintendents of institutions, subject to approval of board of commissioners, and to appoint other necessary assistants. It shall be his duty, among other things, to provide, subject to the approval of the board of commissioners: (1) Proper plan of organization of the department and methods of administration at each institution, and in each division of the department, including provision for the proper distinction between medical and professional administration and business administration. (2) Adequate and proper care and treatment of all wards and prisoners in custody of the state. (3) A central purchasing agency for purchasing all equipment, supplies, materials and other goods for the whole department, including all institutions, together with the adoption of standard and businesslike methods of purchase. (4) A uniform and adequate system of accounts and reports, with provision for all bills of the department, including the institutions, to be settled by the treasurer and receiver-general. (5) Such agencies as will care for all industrial activities of inmates, looking to such a division of the manufacturing interests involved in state institutions as shall bring about the largest possible opportunities for the betterment of the inmates, and, so far as it is possible to work it out in connection with such inmate improve- ment, the greatest possible efficiency from a business standpoint. (6) A better oversight of the farming interests of all state institutions, with such supervision as shall increase the efficiency of present farm organizations handicapped by either bad management or bad conditions responsible for present unsatisfactory results. (7) Standardizing building operations and such technical over- 8 BOARDS AND COMMISSIONS. [Feb. sight of the physical properties connected with state institutions as shall lead to more efficient and businesslike oversight both of property now standing and of building operations that may be undertaken.

Executiv Secreta pji Four executive secretaries (in addition to business agent) to be appointed by the director, subject to the approval of the board of commissioners, same subject to removal by the director, upon approval of the board or by a majority vote of the board. To carry out such directions and orders as may be issued by the director, and to have full authority in their respective divisions and institutions, subject to the director. To be responsible to the director for proper administration of institutions under them and for the care of the inmates thereof. To consult with, advise and direct the superintendents of the institutions as to proper methods of procedure and administration within the several institutons.

Division of Work among Executive Secretaries. The work of these several secretaries would be primarily the direction of affairs in the various institutions, assigned somewhat as follows: Executive Secretary for Insane Boston State Hospital, Danvers State Hospital, Foxborough State Hospital, Northampton State Hospital Taunton State Hospital, Westborough State Hospital, Worcester State Hospital, Gardner State Colony, Medfield State Asylum, Worcester State Asylum, School for the Feeble-Minded Wrentham State School, Monson State Hospital for epileptics.

This is much the largest group of institutions under any one executive secretary, but the work of these institutions is such as to make them one significant group. To begin with, and until reclassifica- 1914.] HOUSE — No. 2137. 9 tions of inmates and patients have been worked out, it would seem better to leave these institutions under one executive secretary, who, of necessity, will require a high salaried assistant.

Executive Secretary for Hospitals and Sanatoric Penikese Hospital, Lakeville State Sanatorium, North Reading State Sanatoria Rutland State Sanatorium, Westfield State Sanatorium, Massachusetts Hospital Schoc State Infirmary, Norfolk State Hospital for inebriatei

Executive Secretary for Pris and Correctional Institut Present work, in part, of office force and agents of the Prison Commission. Industrial School for Boys, Industrial School for Girls, Lyman School for Boys, State Prison, Prison Camp and Hospital, Massachusetts Reformatory Reformatory for Women State Farm

Executive Secretary for Charity. The work under this official would be in a large part such as is now conducted directly by the Board of Charity. This is of itself a large undertaking, appropriation for which during 1913 was $966,187.00, and the estimates for 1914 are $1,201,982.00. It is probable that the work now performed by the Blind Commission and the institutions under it could be assigned to this official.

Business Agent Bo carry out such directions and orders as may be issued to him by the director, and to have full authority in his division, subject to the director. To appoint, subject to the approval of the director, necessary assistants, including a purchasing agent, who shall purchase all goods for the department, including the institutions. Subject to the approval of the director, to devise and install in the depart- 10 BOARDS AND COMMISSIONS [Feb.

ment, including the institutions, improved methods of (a) purchasing, storing and issuing equipment, materials, supplies and other goods; (b ) accounting and reporting; (c) farming and utilization of farm products; {d) constructing institutional buildings, etc. To conduct such other activities common to the business administration of the several classes of institutions as may be assigned to him by the director.

UNPAID BOARD OF THREE VISITORS FOR EACH INSTITUTION. To be appointed by the governor and approved by the council. Allowance to be made for expense and travel. Duties only to suggest for aid in the medical and -correctional features of the administration. In carrying out such duties, the board of visitors to be empowered to hear complaints from inmates, and to report their findings upon such hearings to the commissioners and to the governor and council. Right of appeal to the governor and council in support of any charges of mismanagement in any way whatsoever against the commissioners or executive officers.

Plan 11. SUPERVISION AND ACTUAL CONTROL BY A BOARD OF FIVE COMMISSIONERS, TO GIVE ALL THEIR TIME TO THE DUTIES OF THEIR OFFICES, AND TO BE CHOSEN WITH PARTICULAR REFERENCE TO THE SEVERAL DIFFERENT PROBLEMS INVOLVED, FROM AN ADMINISTRATIVE AND CORRECTIONAL STAND- POINT. In working out an organization along the line suggested as this alternative, the only change necessary to make is to provide that the central board shall be made up of men who are experts in the various lines of work required, and who as a board shall make up the administrative organization for the entire work of all the institutions. The powers and duties which Plan I places in the director, would be placed by Plan II directly under the central board, and it is contemplated that in dividing the work, arrangements would be made by which the work of the executive secretaries would be taken over by the various members of this central board. 1914] HOUSE —No. 2137. 11

FACTORS TO BE CONSIDERED. Advantages may be easily shown in favor of either one of these two plans of organization. Many people believe that only by cen- tering authority in one individual along lines similar to those laid out in Plan No. I can direct responsibility be fixed for administrative work. The Commission on Economy and Efficiency recommends the reorganization in accordance with Plan No. I, as providing the means for determining the responsibility required for successful administration, and presents a bill for such legislation as will be necessary to carry out the full provisions of that plan. It has further presented Plan No. II as an alternative for consideration, so that the advantages of both forms of control may be fully considered. In considering both of these plans great care should be taken to make the proper distinction between the administrative work that is necessary, and any work that may be required from an advisory board having authority to investigate and recommend. Various boards and commissions existing under the present law would necessarily call for attention in providing a new form of administration. Some of these which may be considered are the several parole boards, commissions having to do with the problems of immigration, white slave traffic, cure of drunkenness, care of the blind, and undoubtedly several others with more or less demand upon the consideration of the commonwealth as a part of the great problem involved. It would seem that such an organization as is proposed might provide for a single parole board, where now there are four, and that the work performed by many outside commissions, to whom have been entrusted particular problems, could be performed by the regular administrative officers of the one central department. Provision should be made for the salaries of all officials to cover all duties conferred upon them by the law' creating them, or by special legislative acts referring to them particular questions for consideration, and no additional salary should be paid for any extra services required of them. 12 BOARDS AND COMMISSIONS. [Feb.

ORGANIZATION WITHIN INSTITUTIONS. Reference to the discussion under the head of “Present Condi- tions Considered” will show clearly certain conditions which it is hoped to have remedied by such a central organization as is proposed. Details of administration to be worked out within the individual institution should be left to whatever controlling body may be created and its executive officers, but it is believed that with central control, unhampered by such interference as necessarily follows several different organizations attempting to bring about a single end, such arrangements can be made for carrying on the medical administration and the business administration in the several institutions as to greatly aid in the care of the patients themselves and greatly improve the efficiency of the business administration.

The Commission on Economy and Efficiency has collected a large amount of data relative to the present work, organization, methods and conditions in the several institutions, boards and commissions concerned with the care of state wards and prisoners. All this information has been utilized by the commission in its study of the present situation and in its endeavor to work out a more satisfactory organization for the work. It appears unnecessary to present this information in detail in this report, since it is readily accessible in this office and since a large amount of such data will be presented in the forthcoming general report on the functions, organization and administration of all state departments, boards and institutions. The following tables are presented, however, to show some of the more important data relating to the institutions involved in this discussion, with information as to the character of work, service performed, and officials now engaged in the administration. Institutions UNDER THE SUPERVISION OJ the State Board of Charity (From the Board’s annual report for 1912.

Average Average Appro-A Whan Area Number Capacity Number -upied ™Tnful ollneU- P~ r opened. v n, 1912. 1913-

:l State Far Tewksbury, May, 1854 740 51.053,678 11 2,2832 2,301 320!0 §444 200 1522 2,900 Bridgewater, . May. 1854 1,184 1,682,565 43 2,615 2,900 184 348348,000000 1,924 $3,336,243 54 4,898 5,201 504 $792,200 O of Training Deli: Trustees Massachusetts Schools for Uj

Westborough, . Nov., 1848 396 $451,783 48 359 350 76 $114,000 Industrial Shirley, .... July, 1909 890 201,952 14 178 180 44 68,230 Lancaster, . . Aug., 1856 309 349,523 13 304 78,500 X Totals, Trainii 595 1,003,258 75 841 828 193 $260,730

to >65 $559,938 76 346 350 205 $183,000 North Reading, Sept., 1909 123 139,511 95 173 150 Lakeville, . Jan.,Jan., 1910 75 156,904 31 172172 162 87,300 Westfield, Feb., 1910 178 143,605 21 176 150 70 88,500

741 $999,900 414 8441,665 $53,102 Mi Walpole Aug., 191!! 1,006 36 43 47 17 $20,500 Canton Dec., 1907 85 286,924 55 239 230 03 73,614 for lept Penikese Island, . , July, 1905 100 110,980 44 15 19 4 21,000

5,431 $5,790,469

For transfers from Foxborough State Hos ,1; n yetopen for com: itment Under direct control of the State Board. State Institutions under Supervision op State Board of Insanity. [From the annual report of the Board for 1912.]

Average Average Area Number Capacity Number fvppro-A • , Tntol AMR Location, Whenvvnen occupied Potion foi opened.mened i of of Inati- em- P (Acres) , VValuation.!alua ion , Ex e"ses ’ (p iiiiiuii. pioyea,ployed, P atientstutiiio, tution.i inio 1912. 1912. iyid

llosi . . Worceste Worcester, . Jan., 1833 120,772 §335,250 Boston, 12 1,360 1,289 334 00 Boston (Dorchester), . Dec 1839 34 195,065 22 1,015 1,154 404,500 Taunton, Apr 300 00 Tauntop, .... 1854 988,169 59 1,034 1,073 270 272,300 00 Northampto Northampton, . Aug. 1858 511 1,018.383 00 819 156 186,200 00 Danvers, May Danvers, .... 1878 509 1,847,897 16 1,452 1,366 282 354,600 Westborough, Westborough, . Dec 1886 r OB ,025,190 324 322,350 00 Foxborough, 3 1,190 1,201 Foxborough, . Feb. 1893 103 349,280 88 399 299 78 103,500 00 Totals, hospital W ,97c §9,544,758 50 7,347 7,201 1,744 $1,978,700 00 Asylums for the Asylum Worcester Worcester, , Oct., 1877 15 * Colony, $1,246,609 03 I,lBl* 1,219* 281* $290,900 00* North Grafton, . Nov., 1902 889 Asylum, Medfield Medfield, .... May, 1896 441 1,742,289 30 1,705 1,542 358 357,598 Gardner Colony, Gardner, 00 .... Oct., 1902 1,608 623,241 86 671 650 123 141,500 00 Totals, asylums 951 $3,612,140 19 3,557 3,411 762 $789,998 00 P itals am iums 5,929 $13,166,898 69 10,904 10,612 2,506 $2,708,398 00 Hospital for epilopti Monson, Monson, May 1898 es: $823,626 80 871 853 183 $234,325 00 Cfi (J 2 the feebh ided: Massachu Walthan Oct 1848 160 §1,019,398 62 1,430' 1,140 261 20 89® Templeton, May, 1900 1,814 y Wrenthai Wrentham, June, 1907 495 429.576 w t. sble-minded. 2.469 $1,448,975 34 1,789 ,820

9,085 $15,429,499 83 13,564 13,285 3,012 102,073 89

November 30, 1912. Worcester Hospital and Worcester Asylum direct 1 and controlled by same Board of Trustee Has also a number of cases of inebriety and druf addiction, for whose treatment it was origii .lly estab iln Total for asylum and colony. Aug. 1, 1913, there were 304 officials and employe 125 at Worcester, 179 at North Grafton Totals for school and colony. Aug. 1, 1913, there were 291 officials and employee 244 at Waltham, 47 at the colony. Institutions under the Control of the Prison Commission.

A verage NU ber >' nf CaP acit Number * " Prisoners, Whc occupied Total pf“;d prialieofo, ,POned - (Acres). v r) Se t 0, i9 13? in 17851 0.3 $1,256,800 00 732 800 96 $179,000 1884 308 1,396,517 92 617 950 139 237,900 3 1877 333.24 493,705 89 196 500 66 65,000

Inj 1904 9862 86,023 08 2 60 100

1907 59 100

1,636.54 $3,233,046 89 1,664 2,450 330330 $533,400

Established on present te in 1805 Total for cam; and hospital 16 BOARDS AND COMMISSIONS. [Feb.

Institutions under Supervision of State Board of Insanity.

f = Name of Institution. hmates° Classes of Inmates,

Hospital, Worcester ... 7 1,300 Curable and incurable insane.

Boston Hospital, ... 7 1,236 Curable and incurable insane. Hospital. Taunton ... 7 1,103 Curable and incurable insane.

Northampton Hospital, . 7 872 Curable and incurable insane. Hospital, Danvers ... 7 1,412 Curable and incurable insane. Westborough Hospital, 7 1,237 Curable and incurable insane. Foxborough Hospital, 7 370 197 insane. 173 inebriates 1 (male). Worcester Asylum, 3 7 4 1,150 Chronic insane transferred from hospitals.

Medfield Asylum, ... 7 1,721 Chronic insane transferred from hospitals. Colony, hospitals. Gardner ... 7 688 Chronic insane transferred from

School for the Feeble-minded, . 125 1,441 Male and female feeble-minded.

Wrentham School, ... 7 401 Male and female feeble-minded. Hospital, 1 Monson ... 7 887 Epileptics, sane 535, insane 352.

Total trustees, ... 89

1 On Oct. 1, 1912. 2 The inmates of insane hospitals include a certain number of female inebriates, the number of this class committed to each institution during the year ending Nov. 30, 1912, being as follows:

To Worcester Hospital, ...... 7

Boston Hospital, ...... 1

Taunton Hospital, ...... 1

Northampton Hospital...... 3

Danvers Hospital, ...... 7 Westborough Hospital, . 28 3 Includes Grafton Colony. 4 Same board as of Worcester Hospital. 5 Six appointed by Governor and Council, six by corporation.

The State Prison, Massachusetts Reformatory, Reformatory for Women and the Prison Camp and Hospital are by law placed under the control of the Prison Commission, consisting of a paid chairman and four unpaid members. The management or immediate charge of each of these four institutions is vested in a superintendent, who is responsible to the Prison Commission. The Board of Parole places on parole prisoners in the State Prison, Massachusetts Reformatory and Prison Camp and Hospital, while the Board of Parole for Women performs the same function for women in the Reformatory for Women. The average number of prisoners in these institutions for the year ending Sept. 30, 1913, was as follows: 1914.1 HOUSE Xo. 2137 17

State Prison, o. ■3 Massachusetts Reformatory, G 1 Reformatory for Women, 196 Prison Camp and Hospital: Camp, . . . . 59 Hospital, 62

Institutions undue Supervision op State Boab; ;d op Chaeity

Number of Number Institutionnst tut O- C I . Trustees. Inmates

,233 Infirmai ite paup 1.505 ne 728. paui aks and paupers

Lyman Sch Delinc d. itted

Industrial School for B< 183 Delinquent b< 15 to 1 ;ted

d School for (? Delinquent girls der 17 when committed

Rutland

North Headin' Pu

Westfield S:

Norfolk Hospital iferred from Foxborough Massachusetts Hosp Crippled and de d chili

Hospit Non diet d with lepr<

Total trui

Average f

Members of State Board of Charity, 9 Members of State Board of Insanity 5 Trustees under supervision of State Board of Charity, 28 Trustees under supervision of State Board of Insanity, 89 Prison commission 3

Total number of trustees and commissions 13f

PRESENT CONDITIONS CONSIDI RED

CASES OF DIVIDED AUTHORITY IN THE SUPERVISION OF CEI TAIN STATE INSTITUTION It will be interesting to consider, briefly, the divided authorit affecting some of the different institution IS boards and commissions [Feb,

State Infirmary The State Infirmary at Tewksbury is an institution directed by a board of seven trustees, nominally under the supervision of the State Board of Charity. There were on November 30, 1912, 2,233 inmates at the infirmary of whom 728 were insane and 1,505 were hospital patients. Of the hospital patients 370 were minors, some of whom were feeble-minded. These various classes come within the direct control of the trustees, but involved in the supervision of the institution, beside the State Board of Charity, is the State Board of Insanity, which has the same powers in connection with the mental wards here that it has in hospitals and asylums for the insane, except that it has nothing to do with business matters.

State Farm This institution has the same board of trustees as the infirmary and as a whole is under the supervision of the State Board of Charity. On November 30, 1912, it had 2,598 inmates, 351 being paupers, 1,459 prisoners and 788 criminal insane. Since the insane are all convicts, the insane hospital here is supervised by both the State Board of Insanity and the Prison Commissioners. The Prison Commissioners also have power to transfer certain classes of prisoners to and from the State Farm, some on their own initiative, and some on the initiative of other authorities, such as, in certain cases, the governor and council. Any inmate originally committed to an institution under control of the Prison Commissioners and by them transferred to the State Farm, would apparently come within the jurisdiction of the Board of Parole, though such cases would doubtless be rare. Parole of prisoners committed in the usual way to the State Farm is arranged by the trustees and the State Board of Charity. Massachusetts Training Schooi These schools are directed by a board of trustees, who are under the supervision of the State Board of Charity. The number of inmates at each school on November 30, 1912, was as follows: Lyman School for Boys (boys under 15), 385 Industrial School for Boys (boys 15-18), 183 Industrial School for Girls (girls under 17) 299

Total number, 867 1914 HOUSE —No. 2137 19

All these schools are for delinquent children of the ages noted. No other board than the State Board of Charity has the power of supervision, but the Prison Commissioners may, on application of the trustees, remove a boy from either of the schools for boys to the State Reformatory, or a girl, from the school for girls, to the Reformatory Prison for Women. They are not required, however, to make such removals, and have no authority within any of the institutions. Norfolk State Hospital The State Board of Charity is the only supervising body. The board of trustees is, however, the same as that of Foxborough State Hospital, for which the trustees are under the supervision of the State Board of Insanity. The State Board of Charity has presented a bill to the present session of the legislature for the creation of a separate board of trustees, for this institution. This hospital is not yet open for commitments, receiving patients only by transfer from Foxborough Hospital. The number of inmates November 30, 1912, was about 40.

Insane Hospitals and Asylums. No board other than the State Board of Insanity has any power of supervision over state institutions for the insane, feeble-minded and epileptic. The State Board of Charity, however, is charged by Section 4, Chapter 84, Revised Laws, with the duty of investigating the settlements of paupers in these institutions, and enforcing the laws relative to the support of sane state paupers by cities and towns. (The enforcement of these laws would apparently apply only to institutions for epileptic and the feeble-minded.)

CROSS-PURPOSES IN FUNCTIONS AND ACTIVITIES Attention has been called to certain over-lapping of authority with respect to single institutions. In addition to such an unsatisfactory condition in organization and administration, there is at the present time no satisfactory assignment of functions and activities to the various boards under consideration. A single function is now divided among wholly distinct boards with the result that no one board or department is considering a given function or activity in its entirety. For example, the state’s correctional work is now in 20 BOARDS AND COMMISSIONS [Feb.

part carried on under the supervision of the State Board of Charity and in part under the control of the Prison Commission. The Board of Charity has supervision over the trustees of the State Farm and of the three industrial schools, each of which is a correctional institution, while the Prison Commission has control over the reformatories and prisons. The division of this function among the two state boards and the several local boards of trustees makes it impossible to properly co-ordinate the work of these several agencies. Again, the State Board of Charity is by law visiting and inspecting county training schools while the Prison Commission is by law supervising county jails and houses of correction. No ad- vantage has been pointed out in such a division of the work; it certainly represents some duplication of effort. While it is realized that the care of the insane is a specialized activity, yet but few people realize that the maintenance of the state institutions for insane is but a sub-activity of the broader function of caring for dependents and defectives. This fact is apparent when it is learned that over four-fifths of all inmates of state institutions under the supervision of the State Board of Insanity are public charges, having so far as can be ascertained by the State Board no private means of support. Figures for 1912 have been compiled from data furnished by the State Board of Insanity showing the number and percentage of patients under the supervision of the State Board of Insanity who are state charges and the number and percentage who are supported either in part or in whole by themselves or relatives and friends. These figures are summarized in the following table.

State Ch. Reimbursi: Private Tot C is of Inmates. AveragAverage Average Percent- Average Percent- Average Percent- Numbi age. Numbi

Under family 84.9{

120 4.6 1914.1 HOUSE —No. 2137137 21

DEVELOPMENT OF PRESENT METHOD! Most of the institutions in Massachusetts are doing good work along most of the lines of activity in which they are engaged. That all of the different activities under the direction of a particular board of trustees are not well performed is due not nearly so much to the particular people having these activities in charge, as it is due to the sytem under which the different branches of work are carried on. There is little question but that the original purpose of the creation of the Board of Insanity was to establish a body who would have general control and oversight of all matters affecting the insane wards of the state. Their testimony makes it clear that the actual operation of the present method results in no actual control whatsoever exercised by the Board of Insanity over the administrative features of any insane hospital supposed to be under its care. A similar central control was supposed to be secured through the placing of different institutions under the Board of Charity, but the result has been a failure to control, exactly as in the case of the Board of Insanity. The assumption is that the next step would naturally lead to the control of the institution itself by the particular board of trustees created for its administration. Again, evidence before the commission from practically every board of trustees that has been in- terviewed, and borne out by all investigations which the commission has made, sho'ws that the actual administration of the institution is in the hands of the superintendent appointed by the trustees. The result of this practice by which the official administration of every institution is in the hands of the resident superintendent is that no official directly related to the state itself has any direct control over any one of the institutions, or any one of the particular problems. In nearly every institution where superior work is being done along a particular line, the head of the institution has stated that the peculiar interest which led him to take the position of superintendent was because of a desire to benefit, physically or mentally as the case might be, the particular class of patients cared for in the institution under his charge; in other words, his interest is entirely professional. In almost every other case where there is criticism of the 90 BOARDS AND COMMISSIONS. [Feb.

one in charge of the institution, abundant evidence is available to show that the real interest is very often in the development of the farm, or the working out of some particular hobby at the expense of the Commonwealth, and to the very serious detriment of real, genuine service to the patients involved. The purpose of each one of the institutions of the state is to do some particular good to the patients cared for. The chief factor in carrying on the affairs of the institution should never be lost sight of as resting in the purpose of the Commonwealth to help the inmate; if insane, to cure the insanity; if unfortunate, to provide as com- fortable an existence as possible; if a cripple, to develop the mind and straighten the limbs; and whatever the peculiar need, to perform the peculiar work necessary to relieve the situation. The secondary purpose is associated with the economical and efficient business administration involved in carrying on the affairs of the institution. But if it is secondary, it is nevertheless very important, and because of the manner in which it is performed is not efficient and not economical in many instances, serious consideration should be given to this phase in considering the necessary relief.

WORK WITHIN THE INSTITUTIONS. The Superintendent. It seems probable that under present conditions, superintendents have little opportunity to study the best methods of care and treatment for their patients or to give adequate attention to the funda- mentals which ought to underlie the work of their institutions. They are supposed to superintend both the treatment of patients and the management of the business of the institutions, two entirely different functions which are more or less incompatible. In fact it has been admitted in annual reports of the State Board of In- sanity that it is almost impossible to find men who are both good physicians and good business managers. In addition to this broad conflict of duties, the superintendents in most of these institutions have so large a number of persons reporting directly to them that much of their time must be taken up with small matters of detail, to which they ought not to be required to give attention. Considering some of the larger institutions we find that in Worcester hospital there are 17 departments, in Boston hospital 23, in Taunton hospital 24, in the School for Feeble-Minded 23 HOUSE No 2137

24, and at Gardner Colony, which is not an exceptionally large institution, 22. This does not necessarily mean that these institutions are divided into a large number of small departments with a few employees in each, but rather that in addition to a comparatively few large and important departments there are a large numl of very small ones in which one, two, or three people are responsible to no- one except the superintendent, either through a foreman or Erectly. In various institutions we find ward matrons, dinin room matrons, stenographers, cornet teachers, night watchmen, construction laborers, cooks, laundresses and seamstresses reporting to the superintendents, though all of these, or practically all, are doir work on matters of minor detail. In some cases, the responsibility of these persons to the superintendent seems to be largely a personal matter, because the employees in question do not get along with the official who ought to be their superior, but generally it appear due simply to a lack of system. Further, there has been apparently little standardization of de partments in these institutions, either as to what departments there shall be or as to what each shall comprise, so that the superintendents in the different institutions have varying organizations, some of which entail much more burdensome duties upon them than others. In three institutions coming under the supervision of the State Board of Insanity the superintendent is required to do the purchasing for the institution, one of these institutions being the School for Feeble-Minded where the strongest recommendation for the employment of the present superintendent is that he is an expert in the care of the kind of patients with which he is supposed to deal. It might be submitted that in such a case, with all the other duties which he is expected to perform, the superintendent can have little time to give attention to medical questions.

Other Official At most of the twenty-five institutions under the Boards of Insanity and Charity, there is some official, occasionally two officials, who have some part in the business management. Thus, in 10 of the 13 institutions for the insane there is a steward, and in 7 there is a treasurer, some of the institutions having both. One institution has both treasurer and steward, but the steward is little more than a head kitchen man, and the treasurer does the pur- 24 BOARDS AND COMMISSIONS [Feb chasing. In other institutions the treasurer, while receiving a salary equal to that of the steward, and sometimes exceeding it, is little more than a head bookkeeper, and most of the business details are entirely in the steward’s hands. Both these officials are nominally subordinate to the superintendent, but the usual situation is that either or both are practically independent and manage their departments with little or no direction. While the treasurer’s department, if there is a treasurer, is usually limited in size, the steward’s department varies greatly from one institution to another. For example, at the Westborough Hospital there are 71 employees in the steward’s department, and he has charge not only of purchasing and storing the supplies, but apparently in practice, of all cooking and most of the serving in all parts of the hospital. In Worcester and Taunton hospitals the steward has charge not only of the supplies but also of the farm, and the head farmer is subject to his direction, whereas in most other institutions the head farmer is a separate official reporting directly to the superintendent. In fact the employees under the steward’s direction vary so greatly from one institution to another that it is absolutely impossible to predict after studying one institution what employees will be found under the steward of the next considered. This lack of standardization is very unfortunate, because it makes it practically impossible to tell, without a separate study of each hospital, asylum or school, just what work is being carried on by this important department in each one. This situation is not by any means peculiar to the steward’s department, however, as almost all the other departments are equally, or almost equally unstandardized. The matron’s department, for example, is usually more or less related to that of the steward, since the matron is the general housekeeper of the institution, and so has charge of the physical condition of the wards and buildings, beginning as a rule at about the point where the jurisdiction of the steward ends, but since the jurisdiction of the steward is variable, that of the matron must necessarily be variable also, and while in some institutions we find that the matron is subordinate to the steward, in other institutions we find her wholly independent, and whereas in some institutions she has practically nothing to d'o with either the kitchens or the dining rooms, in other institutions she has full charge of both and superintends cooking and serving of all meals. 1914 HOUSE No. 213 25

In some institutions also, we find all construction laborers grouped under one head, usually called a foreman or superintendent of construction, but these institutions are few, and in most cases the head carpenter, the head painter and the head mason, if there are more than one of each, or the single carpenter, painter and mason, report directly to the superintendent, while in a few cases the head carpenter has charge of the other mechanics. The same situation is practically as true of the institutions under the supervision of the State Board of Charity as of those supervised by the State Board of Insanity, though the dissimilarity of work among the charitable institutions is so great, the comparisons are less significant. Though we find in most cases a large number of departments reporting to the superintendents, who are generally supposed to be both medical and business men, and frequently to do their own purchasing, we find a great variety of different officials comprising these various departments, so that the different superintendents have reporting to them laundry matrons, chefs, wood- workers, instructors in various industries, seamstresses, watchmen and other employees. It must be admitted, however, that under the State Board of Charity, institutions of a similar character tend to be organized somewhat alike, and that in the main they have characteristics in common. For example, in the three industrial schools, there are 13 departments in each of the two schools for boys and 11 in the school for girls; and in the four sanatoria two have 8 departments, one has 9 and one has 10, and that in spite of the fact that the one with 10 departments had at the time only 72 employees while the one with 9 had 212.

Employees. It is noteworthy that there appears to be no standard in these various institutions by which is determined either the number of employees necessary to do the work, the salaries which they are to be paid, or the titles by which they are to be known. This lack of a standard in these three matters is very confusing, especially as the absence of comparable titles in so large a number of cases makes it almost impossible to tell what the work of a large number of employees may be, and so to compare their duties and remuneration with those of employees who may ultimately prove to be doing almost exactly the same kind of work in some other institution. 26 BOARDS AND COMMISSION Feb.

A single example of this variety of terms may suffice to indicate what is meant. In most institutions there are a few employees who do general work, such as moving cooked food from the kitchen to the serving rooms or from the bakery to the serving rooms, cleaning about the basements and kitchens, taking some care of the grounds, and other heavy work such as moving furniture, beat- ing rugs and the like. Not all the employees in mind do all these things, but almost all of them do similar work and would seem to be likely to have similar titles. But instead of having similar titles, they have very dissimilar ones, as in some places they are known as porters, in other places as basement men, occasionally as jani- tors, sometimes as general workers, while in one institution two employees doing this sort of work are known as a carman and a pickup. The varying number of employees required to do the work in similar institutions is also noteworthy. It is probably best indicated by the ratio of employees to inmates in the various institutions, especially in the institutions under the supervision of the State Board of Insanity, because these institutions are in the main similar in their character and purposes. We find that one hospital has as many as 1 employee to 3.38 patients, while another has 1 employee to every 5.75 patients, and that in the asylums the ratio varies from Ito 4.20 to Ito 5.45. This variation is not so extreme, however, as is noted when the ratios of persons employed in the medical and ward service to the inmates under their care are worked out. When these ratios are considered we find that while one hospital has a doctor or nurse to a little over every five patients, another has one such employee to each group of more than ten patients, the total variation between the institution -with the lowest ratio and that with the highest being from a ratio of 1 to 5.31 to a ratio of 1 to 15.35. In these circumstances it would seem either that one of these institutions has far too many employees, or that the other has far too few, and in either case the situation requires correction. The institutions under the State Board of Charity show an equally great variation, but such variations are of less consequence when it is considered that they are doing very dissimilar work, and that those doing similar work show in most cases a similar ratio. One of the institutions under the State Board of Charity, however, namely. 1914.] HOUSE —No. 21372137 27

the Rutland State Sanatorium, shows a remarkably high ratio, having had an average during the year 1912 of 1 employee to much less than every 2 patients, the exact ratio being 1 to 1.69. It is noteworthy also that this ratio is much higher than the ratio for the other three sanatoria, the ratios for Lakeville, Westfield and North Reading being 1 to 2.39, 1 to 2.51 and 1 to 2.58 respectively. Probably there are some special conditions at Rutland which would perhaps tend to increase the number of employees, but a smaller number would doubtless do all necessary work. It might also be noted that the ratios of employees to inmates at the three industrial schools are very similar, being 1 to 4.05, 1 to 4.16 and 1 to 4.75 for the Industrial School for Boys, Industrial School for Girls and the Lyman School for Boys, respectively. Prob- ably the reason for the somewhat lower ratio at the Lyman School for Boys is the fact that the boys there are younger and so are, perhaps, more easily controlled. The largest discrepancy in the ratios under consideration appear between the State Infirmary and the State Farm, which while not by any means similar institutions have to a certain extent the same problems, since both have wards in which are confined several hundred insane patients. In both of these institutions the ratio of employees is much lower than in the case of any other institution under the State Board of Charity, but the ratio at the State Farm is almost twice as low as at the State Infirmary, being at the farm only 1 employee to every 14 or more inmates, while at the State Infirmary there is 1 employee to about every seven inmates. Lack of uniformity in salaries and wages seems to be character- istic of almost all institutions in these two departments. In the institutions for the insane, feeble-minded and epileptic which are supervised by the Board of Insanity, the highest salary of a superintendent is $5,000 and the lowest salary $2,500; but there is not so great a lack of uniformity as appears, since ten of the superintendents at these institutions receive $3,000. The superintendent of the Boston hospital is paid $4,000, $l,OOO of which is in consideration of his services in connection with the Psychopathic hospital. Considering other salaries, however, we find greater variations. Assistant superintendents, who in the main do medical work, receive from $1,500 to $2,000 a year, male physicians from $6OO to $l,BOO a year, female physicians from $6OO to $1,500 a year, pathologists 28 BOARDS AND COMMISSIONS. [Feb, from $l,OOO to $2,500 a year, treasurers from $l,OOO to $2,000 a year, and stewards from $1,200 to $2,000 a year. Further instances of these variations among officials could easily be cited, but probably more important is the fact that there is very considerable variation among minor employees, particularly those having direct charge of inmates, such as attendants and nurses. Thus we find the salaries of ma e supervisors, assistants, and head nurses varying from about $22 a month to over $57 a month, while male attendants and nurses receive from about $2O to $45 a month. Similarly female supervisors, assistant supervisors and head nurses receive from $2O to $5B a month and female attendants and nurses from about $l6 to over $43 a month. A certain amount of this variation is due to the fact that employees in the ward service of the various hospitals and asylums shift rapidly, so that many of them have little chance to acquire increases in remuneration through service. Nevertheless the variations are considerable. It should be notedalso thatthe majority of the nurses and attendants who are really the bulk of the working force on the wards get comparatively small salaries, three-quarters or more of the total receiving $3O a month, or less, and a very large number $25 or less per month. This, of course, includes maintenance, but it should be considered that much of the work of nurses and attendants is of a peculiar and exacting character and that these rates of pay will not secure experts to do this work.

SOME RESULTS OF PRESENT METHODS. The Commission on Economy and Efficiency desires to state em- phatically its cordial appreciation and acknowledgement of the generous service given to the commonwealth by many physicians who, in one form or another, have had so large a part in conducting state institutions, and to call particular attention to the fact that any criticism of their methods of doing business must not be con- strued as such an arraignment of their administration as does not fully recognize many of the good things they have done and are doing. In such a reorganization as is recommended, the commission is emphatic in its belief that the time has come for a complete divorce- ment of the business administration in the various institutions of the state from the correctional administration, whether the latter be 1914.] HOUSE No. 2137. 29

medical, social or disciplinarian. Reasons further justifying this con- clusion are contained in the following review of the methods main- tained in the different institutions in performing the special work of accounting, farm management and building construction.

ACCOUNTING. The Commission on Economy and Efficiency has visited nearly every institution of the state charged with the responsibility of caring for state wards. ,A careful investigation has been made at each institution visited, of the accounting methods followed, and in practically every institution serious conditions have been noted. The general system of accounting is under the direction of the State Auditor’s department. Methods have been prescribed by that department for the keeping of accounts, and standard books have been furnished in which records are supposed to be entered. It is the custom of the Auditor’s department to have one of its representatives visit the institutions of the state at stated periods, for the purpose of making an audit of accounts within the institutions, and, so far as can be learned by the commissioners, such visits are made. Each institution has an individual treasurer, who is responsible for the cash entrusted to his care, the payment of bills, the taking of discounts, and the general financial matters associated with the expenditure of whatever money is appropriated for the use of the board of trustees. No uniform custom is followed in the selection of such a treasurer. In some cases the treasurer is a member of the board of trustees; in others, a bookkeeper who supervises the accounting methods of the institution itself; and in others, a separate official sometimes located at the institution, and sometimes doing the work at his own home business office; frequently the superintendent of the institution is treasurer. In most of the institutions the steward has direct charge of practically all of the purchases and of the issuance of supplies. He is aided in his work by a storekeepe , sometimes an inmate of the institution and sometimes a regular mployee. Requisitions are supposed to be used by which differen supplies may be traced from the original request to the final entrj of same book provided to show the distribution upon which may be based an apportionment c ff expense to the different departments within the institute 30 BOARDS AND COMMISSIONS. [Feb,

Payroll sheets are prepared at the institutions, in duplicate, and all accounts are supposed to be audited before final approval for the payment is made. Special books are provided for making record of different appropriations, with such apportionments of the appropriation as are fixed in the original appropriation bills. Outside of the above memoranda specially referred to, such accounting records as are carried at the institution are determined by the exigencies of the particular cases. The commission is convinced that, under the present method, it is impossible to control the affairs of the institutions from the accounting standpoint, so that any accurate record can be presented of the actual expenditure of money for any one particular purpose, or the actual distribution of supplies to any particular department. The commission found in practically every institution that, while it is the duty of the accounting department to post all requisitions to the distribution book, such work was in an uncompleted state, with back posting dating from a month to nineteen months. The commission found that the system of handling requisitions was by the use of a single slip, frequently changed in its travels from the time of original making to the time when it was to be entered as a charge against the department; and the records of stores were such as to lead the commission to believe that only by a complete and full stock taking, without any reference whatsoever to record books which are supposed to show a complete story of supplies on hand, could an accurate statement be made of the exact condition of supplies in stock, or of goods received and delivered. No records are kept of the investment by the state in the permanent plant of the institution, only as they are shown by the methods employed in some of the institutions of adding from year to year whatever money may be appropriated under “special appropriations,” and letting the sum of money so appropriated represent the entire investment in the plant account of the particular institution. If such were an accurate record of such investment, it would not be difficult to determine the exact amount of money which the state has expended for a permanent investment in any particular institution, but, unfortunately,' such is not the case. Under appropriations made for maintenance, which are asked for under several different headings, there is available in the aggregate for all the institutions a very large sum of money which may 91 1914.1 HOUSE Xo, i 31

be diverted from any possible use associated with maintenance meeting demands which should properly come under “special appropriations.” The principal sources from which such money can be, and is, diverted from appropriations for maintenance to relieve special appropriations are “farm, stable and grounds,” “furnishings,” “repairs and improvements,” and “salaries, wages and labor.” It is impossible to find how much money is taken annually in each of the institutions from the above items and used to relieve special appropriations, but, from the investigation made by the commissioners, we believe that a very large amount of money is each year appropriated by the legislature for maintenance purposes at different institutions, which should properly be charged to the construction work carried on at the institution for that year. Appropriations are made by the legislature explicitly stating that a certain sum of money is appropriated for the construction of a building and for its furnishings. In hardly a single case that has come under the investigation of the commissioners has there been an instance where such furnishings have been paid for entirely out of the special appropriation, but in almost every case the special appropriation has been supplemented by expenditures from the item of “furnishings,” which wr as supposed to represent a part of the annual maintenance expense of the institution. Relief for the construction of the building itself comes in practically every case, that has come to the attention of the commissioners, from the items headed “salaries, wages and labor,” “repairs and improvements,” and “farm, stable and grounds;” and these various divisions are so managed that it is impossible to tell what part of the expenditure charged to them, properly belongs under permanent improvements and should become a part of the recorded investment of the state in the plant of the institution. Payrolls are made up from all sorts of memoranda, and are not accurate records of the labor of each employee from day to day. The construction of concrete walks, the investment in various kinds of permanent improvements, and practically every factor entering into the development of the institution which can be provided for out of the maintenance appropriation fail to be recorded in any manner as a part of the plant, although many such items figure in the annual “inventory” as estimated “assets.” One of the most serious lapses noted in the entire system of ac- 32 BOARDS AND COMMISSIONS. [Feb. counting is the absence of any record which shows air exact account of the contribution by the farm to the maintenance expense of the institution. Certain farm accounts are kept, as a matter of convenience to the farmer in charge, which show the production, and in some of the institutions further records are kept by the steward which show the receipts of farm products. No comparisons are made between these records, and, as a matter of fact, in some cases they are simply memoranda carried for the convenience of the man who makes them. These details are sufficient to call attention to the present methods followed in the matter of accounting at the different institutions, which justify the commission in believing that one of the most important advantages to be secured from a reorganization of state institutions may come through the installation of uniform and proper accounting methods controlling a proper division of expenditures, so that the state may have an accurate record of its permanent investment and a better knowledge of its maintenance cost, as well as a more efficient management of its purchases through a central agent, and a more businesslike handling of finances by the state treasurer’s department.

FARM MANAGEMENT The state possesses at several of its institutions farms of a very high standard. At a number of the institutions the conduct of these farms is worthy of the highest praise. In many of them there has been gathered together an organization and an equipment that probably give to the farm a very high rank among the farmers of the commonwealth. Some advances have been made by the state boards in direct relation to the farms along the lines of more efficient equipment and more effective management, but farm accounting, as it is understood by men who make a business of this important industry, is an almost unknown quantity in the farms of the state institutions. The records kept by the farmers are very inadequate; and a large part of the farmers’ time, frequently charged by the institution and almost universally considered by the public as an expense connected with the actual work of the farm, is given to the construction of new buildings, stable service for the institution itself, and work around the grounds, all of which should be charged up to other departments and which should be shown by proper Cost of Producing Milk at State Institutions, Table I. Summary.

(Quarts) Institutions’ Esti- Yield per op op TotalCost Net Cost Total Average Cow. mate Cost Milk INSTITUTION. of of Number in Number per Quart. Production. Production. Herd. Cows. Milch inal Revised Per Year. Per Day. Estimate.

Boston State Hospital, $11,675 16 $8,784 27 59.67 51.58 3,164.4 8.67 $0 465 Danvers State Hospital, 23,907 13 21,476 71 157 85 H 4,140 11.3 0807 Foxborough State Hospital, 5,104 72 3,862 67 43 22 3,455.5 9.46 $0 03 0508 Gardner State Colony, 8,284 96 6,578 68 71 48 3,397 7+ 03 0403 Industrial School for Boys, 6,535 99 5,656 99 78 35 4,162 10.3 0389

Industrial School for Girls, ..... 7,500 79 6,844 94 49 35 2,693.7 7.3 07+

Lyman School for Boys, ...... 5,109 45 4,601 10 63 40 2.849.78 7.8 03 043 Massachusetts Reformatory (Concord), 8,484 93 6,191 93 53 24 4,795 13 035 0538 Massachusetts School for the Feeble-minded, 15,385 47 10,130 88 151 Medfield State Asylum, 33,719 62 29,252 62 193 136 4,182.8 11.4 03 051 Monson State Hospital 17,340 10 15,941 10 106 80 i 9.5 03 0589 Norfolk State Hospital 1,503 29 1,359 29 9 4 4,258 11.666 0798 Northampton State Hospital, 17,540 00 15,258 75 128 65 i 12.9 035 0499+ Reformatory for Women (Sherborn), .... 8,160 23 6,907 66 60 43 3,734 10+ 035 044 Rutland State Sanatorium, ..... 8,606 67 7,971 67 45 30 4,060 11.1 0654 State Farm (Bridgewater), ...... 15,468 89 127 75H i 12 0452+ State Infirmary (Tewksbury), . . . . . 8,675 95 6,131 91 42 42 2,079.6 5.6 0702 Taunton State Hospital, 22,305 31 20,615 31 162 89 2,854 7.8 035 0802 Westborough State Hospital, 19,774 75 17,659 39 150 90 i 10.7 035 0499 Worcester State Asylum, 11,207 44 9,150 37 si'A 56 2,022.10 5 54 08+ Worcester State Hospital, . 21,631 67 18,957 01 136 72^ 5,497.73 15.06 03 0477 Wrentham State School, 4,478 74 3,958 60 43 28 3,011.6 8.2 03 046

i Not reported.

Cost of Producing Milk at State Institutions. Table 11. Cost of Production.

A Straw,Straw, Medicine C f Hayand Sawdustd USt "■ Institution. Labor. Grain. Salt. Interest. pur- l“° Feed- Tnandd chased duction. Shavings.lavings. Expense.

Boston State Hospital, .... sll,67s 16 $1,794 00 $2,414 19 $4,268 75 $1,006 50 $lO 50 $l5 00 $1,187 22 $979 00 Danvers State Hospital, . . . . 23,907 13 5,833 20 4,910 61 9,300 00 1,250 00 $75 00 $707 82 20 50 50 00 1,760 00 Foxborough State Hospital, 5,104 72 927 24 1,010 15 1,667 72 838 01 60 00 - - 411 60 190 00 Gardner State Colony, , 8,284 96 930 00 1,770 39 2,878 00 720 00 378 32 65 3 00 1,083 60 521 00 Industrial School for Boys, 6,535 99 1,160 00 1,622 13 2,185 00 550 00 150 00 136 46 - 732 40 Industrial School for Girls, 7,500 79 1,363 33 1,094 66 2,576 00 873 00 100 00 - - 708 80 785 00

- - Lyman School for Boys, .... 5,109 46 600 00 2,158 11 1,805 00 176 00 75 00 39 00 256 35 Massachusetts Reformatory (Concord), 8,484 93 2,145 00 2,407 53 2,144 00 750 00 173 60 - 92 00 372 80 400 00 Massachusetts School for the Feeble- minded, 15,385 47 2,019 55 5,452 10 5,676 33 206 00 74 68 173 33 - 1,213 48 570 00

- Medfield State Asylum, .... 33,719 62 6,465 90 17,027 07 4,724 50 1,996 00 240 00 965 00 75 00 1,926 15 300 00

Monson State Hospital, .... 17,340 10 2,700 00 4,152 92 6,220 82 2,020 00 18 59 18 02 82 25 800 00 1,327 50 Norfolk State Hospital, . 1,503 29 728 04 289 25 200 00 84 00 32 00 24 00 - - 146 00

Northampton State Hospital, . 17,540 00 2,972 00 2,754 00 7,940 00 120 00 100 00 3,654 00 Reformatory for Women (Sherborn), 8,160 23 2,050 00 1,789 15 3,160 00 192 00 100 00 10 92 12 00 - 846 16 Rutland State Sanatorium, 8,606 67 1,956 00 2,562 84 2,448 46 405 00 413 16 4 80 - 816 41 State Farm (Bridgewater), 15,468 89 3,018 72 3,184 77 7,200 00 690 00 138 00 - - 1,237 40 State Infirmary (Tewksbury), 8,675 95 2,150 72 2,604 88 2,952 75 20 00 947 60 Taunton State Hospital, 22,305 31 3,421 00 9,193 06 2,695 00 2,063 50 100 00 144 75 - 13 00 2,800 00 1,875 00 Westborough State Hospital, 19,774 75 4,139 50 7,844 53 5,998 75 520 00 120 00 - 1,151 97 Worcester State Asylum 11,207 44 1,488 00 3,468 94 2,966 36 458 72 140 50 16 50 58 06 1,246 12 1,364 24 Worcester State Hospital, 21,631 67 5,640 00 3,804 20 7,119 12 2,042 14 250 00 106 00 33 00 42 00 2,595 21 Wrentham State School, 4,478 74 445 60 1,442 79 1,226 15 300 00 50 00 396 20 618 00

Cost of Producing Milk at State Institutions.

Table ]JI. —■ Credits.

Institution. Total Credits. Manure. Beef. Hides. Calves. Veal.

Boston State Hospital, $2,890 89 $1,200 00 $1,385 00 $lB2 89 $123 00 Danvers State Hospital, . 2,430 42 696 00 1,228 14 225 13 175 00 $lO6 15 Foxborough State Hospital, 1,242 05 789 50 374 31 78 24 Gardner State Colony, 1,706 28 885 00 635 84 98 44 107 00 Industrial School for Boys, 879 00 600 00 279 00 Industrial Schoolfor Girls, 655 85 288 00 340 01 27 84 Lyman School for Boys, 508 39 450 00 58 36 Massachusetts Reformatory (Concord), 2,293 00 765 00 1,528 00 Massachusetts School for the Feeble-minded, 5,254 59 4,512 00 249 68 101 41 391 50 Medfield State Asylum, 4,467 00 3,750 00 717 00 Monson State Hospital, 1,399 00 600 00 452 00 257 00 90 00 Norfolk State Hospital, 144 00 144 00 Northampton State Hospital, 2,281 25 659 00 975 00 656 25

Reformatory for Women (Sherborn), ...... 1,252 57 784 75 99 70 297 20 70 92 Rutland State Sanatorium, . . . 635 00 400 00 235 00 State Farm (Bridgewater), State Infirmary (Tewksbury), 2.544 04 753 75 1,363 58 223 18 15 00 188 55 Taunton State Hospital, . 1,690 00 500 00 1,030 00 160 00 Westborough State Hospital, 2,105 36 900 00 955 33 250 00 52 10 Worcester State Asylum, . 2,057 07 750 00 1.246 87 8 10 Worcester State Hospital, 2,674 66 2,025 00 156 18 493 50

Wrentham State School, . 520 14 450 00 35 12 5 02 30 00

1914.1 HOUSE No. 2137 records in ail the different details. No better illustration of varying conditions of farm efficiency at different institutions can be brought to the attention of the public than through the publication of data bearing upon the cost of producing milk at the various institutions, and presented in the accompanying tables. Conditions surrounding the production of milk at institution farms have been carefully investigated by the commissioners, and, with the exception of the data furnished by the School for Feeble- Minded, the commission believes that the record presented in the accompanying tables is as accurate a statement of the exact cost of producing milk at the various institutions as can now be prepared. One of the most interesting items to be noted is contained in the column which fixes the cost of producing milk by the haphazard methods that have been followed by the institutions at 3 or 3Uz cents per quart, submitted in the preliminary statement made to the Commission on Economy and Efficiency. The other records presented were furnished by the institutions themselves in response to requests for details, and in each case are acknowledged to be the proper items chargeable to the cost of milk. The figures make an interesting statement of not only the marked difference which the actual figures show as the cost of this product, in comparison with the original ideas set forth by the institution heads, but also show the wide differences existing at different institutions in many of the items which go to make up this complete report. Farm efficiency is at a high standard in a number of the farms at state institutions. Farm efficiency is at a very low standard in a number of other farms, and the commission believes that relief from this condition can be secured only in the fixing of standards to be applied to the management of all farms through a central control which will adapt each institution farm in the commonwealth to the peculiar work which it can best do because of its location, and ivhich will otherwise work out efficient service for all the institutions BUILDING CONSTRUCTION The problem of constructing buildings to care for the many activities of the commonwealth becomes more serious each succeed- ing year. Various state institutions call for improvements and changes at every session of the legislature. The following tables showing the amount of money expended under different classifica- tions for the last tw'entv years is of interest in this connection. 34 BOARDS AND COMMISSIONS. Feb.

Cost of Construction of Buildings,

Met ™P°]!ltan Charitable Year. Correctional 1 Armories. Houses. Institutions. Buildings. Institutions

189; 11,345 30 $176,634 53,943 72 18S 22,718 32 1895 112 10,291 63 1890 89,112 31 1897 94,280 74 189 J 00,791 77 189S 46,695 13

11 11 1 >24 74

136 11,421 47( 188,911 1910, 563 05 175,000 00 403,001 62 64,831 66 380,854 34 143,192 40 191 158,600 00 118,713 96 25,532 23 186,251 12

1175,314 74 $2,1 S: 803

Y EAE Insane Institut Amount

1893 to 1912, inclm ;te State Hospital, 48 1893 to 1912, inclusiv 1893 to 1912, inch Northampton State Hospital, 460 65 1893 to 1912, incl Westborough Stats Hospital, 1 61 1893 to 1912, incl Medfield State Asylum,Asylum, ..... 1,103,156 1893 to 1912, incl the Feeble-minded, . 726,382 43 1893 t Hospital for Dipsomaniacs, 19,770 0' 1912, 1897 to inclusiv Hospital, ..... 461,447 56 M Hospital for Epileptics, . . 24,478 39 1899 to 191 Worcester State Asylum, ..... 774,000 00 1899 to 1912, inch Gardner State Colony, 571,500 00 1899 to 191 Wrentham State School 523,600 00 1899 to 1912,2, irinclusive, . . . Monson Stateite Hospital, ..... 593,540 00 1899 to 1912. inclusiv Boston State Hospital, ..... 1,149,000 00 1899 to 1912, inch: Removal Worcester Asylum to Grafton CColony, 400,000 00 1899 to 1912, inclusive, . . PurchasePi of Boston Insane Hospital, . . 1,000,000 00 1899 to 1912, inch ate Farm, 900 00 1899 to 1912, inch ■y ,te Infirm; 1899 to 1912, inch :h tate Hospital, 150 00

40,282,982 46

Figures for educational institutioi •n; ire appropriationsfor special purp enstruction not kn at included in twenty-year period md, build: •urnishings when not sep;

While there has been included in the foregoing tables practically all of the building operations of the state in this period, it will be noted that of the nearly $19,000,000.00 represented approximately $14,000,000.00 has been devoted to the development of the institutions considered in this discussion. The total amount represented in the above figures is $18,918,200.00, but this amount 1914.] HOUSE —No. 2137. 3o represents only a part of the total expenditure for the purposes noted. The different items charged to the different years and to the different institutions, so far as the insane and charity interests are concerned, do not represent the actual cost of the buildings constructed, for in nearly every institution of any size and importance in the state there has been created an organization of mechanics to take charge of the work on new buildings, under the direction of the institution itself, frequently employing in that work many of the inmates, and frequently spending, in the promotion of that work money available from regular appropriations along methods re ferred to in the reference made in this report to the accountin systems at the different institutions. Under the conditions, no accurate record can be made of the real cost of the buildings owned by the state at the present time, or the cost of constructing any one particular building at any institution The development of an organization for building construction at many of the different institutions has been brought about in a natural manner, and this commission believes that such a development is to be commended, if properly directed. The greatest factor in the consideration of such development is the benefit conferred upon the inmates who may be made a part of such a building organization. Every reasonable condition controlling the trades involved should be complied with in organizing the regular employees where new buildings are to be constructed by the commonwealth. In some institutions it is doubtful if such an organization can be made an economical producing force, but wherever it is possible to combine with the work of such an organization the labor of many men who can be physically and mentally benefited by such w'ork as they are capable of doing in the construction of new buildings, this commission believes that every encouragement should be given to the employment of such a method in constructing state building; If it is possible for the institution to maintain a regular force of workmen who, in addition to the skilled labor they may perform in their various trades, are willing to co-operate in the direction of the inmate patient -whose health is benefited, whose mind is kept easier and -whose whole life has been made a little more worth while, they will be having a part in both lines of this important work, and the commission believes that this policy should be developed and extended in every particular manner. 36 BOARDS AND COMMISSIONS [Feb.

Conforming to this belief, the commission has given very careful attention to the building problems which have come to its notice during the past six months. In their investigations they have been convinced that many of the present methods followed in working out the engineering and architectural features connected with the public buildings of the state are produced along extravagant lines. Architects are chosen in many cases because they are able to present to a particular board of trustees a particular idea in architecture, and standardized buildings are unknown even where the care of similar groups of patients within the commonwealth is concerned. Buildings which serve similar purposes have been erected within three years in this state, varying in cost between different institutions of from fifty to one hundred per cent. The many different boards of trustees have many different ideas and many different preferences, both in the selection of architects and in the peculiar features which they believe should be worked out. In many of the institutions this work is left almost entirely to the direction of the regular institution superintendent. He adds this work of overseeing the construction of buildings to his many other duties. In institutions where large sums of money are being expended, this involves a call upon the superintendent’s time of large proportions. Sometimes he is a practical man; more frequently he is very'impracticable, and the result of his lack of knowledge of the practical features entering into building construction has burdened the state with a very large, unnecessary expense. The state boards have shown by their testimony to this commission that they feel no responsibility for building operations, but leave the responsibility for such work to the several boards of trustees of the different institutions. In a number of cases the different boards of trustees have stated that they leave such matter; entirely to the superintendents. The state has no direct responsibility for either good or bad results. Under the present system of administration it may be interesting to note one of the most seriou; examples of such lack of responsibility in the construction of new buildings at one of the important state institution In 1902 the trustees of the Worcester State Asylum were authorized by the legislature to begin the development of a colony at Grafton. In 1912 it was voted by the legislature that the colony at Grafton should be further developed by the addition of such 1914.] HOUSE Xo 2137. 61 necessary buildings as would provide for the removal, within three years, of a certain portion of the patients at the Worcester Asylum to Grafton. In carrying out this work the state has appropriated up to the present time the approximate sum of $700,000.00, the larger part of which has been expended. From the time of the in- ception of the work to the present, so far as the commissioners can learn, the direction of affairs in connection with the expenditure of this large sum of money has been left almost entirely to the superintendent of the institution, with more or less oversight by the trustees of the Worcester State Asylum. In carrying out the plans provided, 935 acres of land were purchased, and from all records ob- tainable, the matter of the location of the buildings, working out the engineering problems and practically every detail associated with the development of this institution has been in the hands of the person referred to. In connection with the construction of a building for which the legislature of 1913 appropriated a certain sum of money, a request was made to the Commission on Economy and Efficiency to approve some method by which there could be made available for the com- pletion of a service building at one of the groups within this colony an additional sum of practically $8,000.00. With this request as a basis, the commission began an investigation of the manner in which money had been expended and the development work had been carried on at this institution. The question of whether or not this particular building shall be constructed will come before the legislature at this session in the nature of a new request for an appropriation of a sum of money considerably in excess of that appropriated last year. A part of this excess amount is undoubtedly due to the delay incident to the action of this commission in holding up this appropriation; but the commission believed that it was of vital importance that the legislature should be informed as to methods employed by the trustees of this particular institution in expending the money appropriated by the legislature. This particular building is only one of a large group of buildings which appeal to the commission as representing extravagant methods and bad management as the dominant features associated with the entire development of building at the Grafton Colony. The commission gave a great deal of attention to the various 38 BOARDS AND COMMISSIONS. [Feb. features incident to the appropriations, to the original planning, to the control of the institution work, and became satisfied that a radical change should be made in plans and methods of oversight before any further development work should be undertaken at this institution. To satisfy themselves further, in confirmation of their judgment, they called upon the engineering firm of Samuel M. Green Company to make an investigation of building methods at this institution and to report upon the same to the commission. Their report is as follows :

I herewith submit the following report on the building layouts at the North Grafton Colony, Worcester, Mass. I visited the above Colony December 10th, 1913, and made a general inspec- tion of the property, including the layout of the various groups, and I find the following conditions. Location. The property is a beautiful section of the country between Worcester and Grafton, comprising about 1,000 acres. The central portion of the tract is a comparatively level valley, with high lands on three sides, affording some excellent locations for colonies, and making the solution of sewerage and water problems, comparatively easy.

Engineering Features, I find no general or comprehensive plan showing the roads, sewers, water supply, topographical features and proposed location of buildings. In fact no such plan has ever been made, but cross sections are taken of the immediate sites of the various buildings after it has been decided where the buildings shall be located. Cross sections have been made along the pipe lines, but only for purposes of laying the sewers and water pipes and heating mains after the location has been decided upon. In other words, the location of the engineering and architectural projects on the entire property have been determined by reconnoissance rather than as a result of a studied engineering scheme. The water supply I did not have time to investigate thoroughly but the water is now pumped into storage tanks or water towers and then distributed to the various buildings. I did not investigate the heating plants and cannot say if the exhaust steam is all utilized. Neither did I determine whether or not the power plant manufactures the electricity for lighting purposes.

Sewerage. As a result of no comprehensive engineering layout, the sewerage system was designed to drain into the Metropolitan Water Shed and by order of the State Board of Health, the hospital authorities were obliged to redesign and relocate 1914.1 HOUSE —No. 2137. 39 the sewerage system at an expense of 150,000.00, and bring the filter beds in comparatively close proximity to the buildings at the “Oaks” Group. Also the location of the sewer and, I believe, heating pipes, is such that a tremendous amount of fill has been required to cover the pipes. In some places I noted a fill of ten to twelve feet.

Stbeets and Roads. The town roads have been utilized for communication between the various groups and some new roads have been built between sections of the groups, such as the “Oaks,” “Pines” and “Elms.” Grades have been established lam told, on a plan, but have never yet been put into execution on the ground. It would seem that the groups have been located in such positions that it will require a large amount of filling, blasting and regrading, not only on the present existing highways but on those that are contemplated, to put them in a fair condition Location of Buildings, It will be necessary to take up the location of buildings according to the groups. The first group to be considered is the “Elms” Group. In locating this group no topographical survey was made; consequently the buildings have been placed without regard to the natural condition of the ground. The power plant is located in a ravine, with a small hillock to the northward. On this hillock a large building for the insane has been erected, presumably the first building of the group. North of the last mentioned building is being erected a Nurses’ Custodial Building. These two buildings have used all the available level ground, requiring the new buildings now being erected and all future buildings of this group to be located down over the hill into the ravine. As a matter of fact, two buildings just being completed are so far down over the hill that it will be necessary to pump the condensation from the heating pipes back to the heating plant in order to heat the buildin An administration building is being built to the Northeast across the town road, and one building across the ravine to the.West from the heating plant, 1 just been completed In addition to requiring pumping to keep a heating circulation, these buildings have required foundations varying in height from ten to thirty-five feet and also thousands of yards of filling, which filling I am told is hard to obtain, and, as the inmate labor is not sufficient to do this filling, practically all the labor has to be hired. The Administration Building, in my judgment, should have been located south of the road running through this group in the old apple orchard. In my estimation, without careful figuring, the saving of at least $20,000.00 could have been made, this amount being required for extra foundation, thousands of yards of filling and extra roads, extra steam piping, sewerage and water piping. If located in the orchard the buildings would still be far enough away from the housing buildings to avoid disagreeable features. It is now proposed to build a Service Building in the ravine south of the heating plant. This Service Building was laid out and afterwards raised four 40 BOARDS AND COMMISSIONS. [Feb. feet in order to avoid pumping the condensation, but raising the building four feet makes the distance from the 'first floor to the bottom of the foundation in some places thirty-seven and a half feet, making the cost approximately $12,000.- 00 to $14,000.00 for excess foundation work and filling. It will be seen by the foregoing that this group has been laid out without thought or regard to economy, efficiency of service or even permanence, because from the very nature of the locations, the foundations are subject to cross stresses due to frost, which make side hill locations more or less precarious. East of this group is a large, comparatively clear, elevation, which in my judgment would have been a better location than the one chosen. Ample room for the present buildings and twelve or fifteen more of like size and character would have been found, and the problem of heating and drainage, would have been much more simple, and at least $10,000.00 per building would have been saved in foundation work alone.

“Pines” Grot, Tins group is located to the Northwest of the “Elms” group and the conditions here as regards deep foundations and filling are much worse than in the “Elms” group. South of the heating plant is a small knoll upon which two buildings are located, occupying the whole of the knoll. Future buildings must be built down in the ravine if they are built as close to the existing buildings as seems to be the practice of this institution. In fact, a new building being erected already requires approximately forty feet filling on the rear, the floor level being up to the tops of the chestnuts tree back of the building. It will also be necessary to build a culvert to turn a small brook away from this building. In my estimation the sum of not less than $15,000.00 to $18,000.00 has been spent on excess foundations and filling about this one building. To the North of these buildings down a hill is a group of buildings built of wood on stone foundations. All these buildings have required from ten to thirty-five feet of filling. Presumably $50,000.00 has been spent for that purpose and a much greater expenditure will be required for additional buildings proposed at this point. The town road runs to the west of this group. Across this town road the state owns for a distance of about one thousand feet to the west, forming a plateau containing approximately thirty-five acres. Had this “Pines” group been located on this plateau, normal foundations and filling, only, would have been required.

“Oaks” Group. Conditions at this group are exactly the same as in the two preceding. A large Service Building is being erected, which if it had been placed at an angle of 30° with the road, would have required only a normal foundation, but it now requires, roughly estimated, $15,000.00 in excess foundations and filling, and when the proposed wings are built on this building, at least one wing will require foundations thirty to forty feet in depth for practically the whole length of the wing. Locating these buildings on the edge of the ravine toward the swamp 1914.] HOUSI Xo. 2137. 41 brings them in comparatively close proximity to the filter beds, too my judgment. West of the road running to this group is an extension of the plateau mentioned at the “Pines” group, affording ample room to lay out a group many times the size of the “Elms” group, requiring normal foundations only, and not impairing its accessibility to the other groups, inasmuch as the roads would not be relocated. The group would also be moved farther away from th Filter Beds. It will be seen from the foregoing that all the buildings have been located on the hillsides down into the valley mentioned under the heading “Location rather than on the plateau surrounding this valley

Building, None of the buildings in the Colony are of fireproof construction. In several instances the buildings above the foundation are entirely of wood. The foundations are built of rubble stone taken from the land adjacent and a minimum of cement and concrete is used inasmuch as the sand pits are from one to two miles distant from the various groups. This is undoubtedly an economical foundation provided the buildings were 3 located that a foundation of normal depth could be used, but it is readilj parent that so much money has been expended in building these deep four iations and in filling inside and out it is impossible to obtain appropriations large enough to construct the buildings of fireproof material. Had the buildings been located to permit the use of a normal foundation, in my judgment every building in the entire Colony could have been made absolutely fireproof for less than the total expenditure to date.

In General. In my judgment it would be highly improper to allow any more buildings to be built at this Colony until a comprehensive survey has been made relative to the location of future buildings, sewers, water supply and heating, together with all streets and highways necessary. The Service Building at the “Elms group should not be authorized until new7 location has been investigated. It would seem that this building might b located to the northeast of the heating plant and if future buildings in this group were erected on the rising ground to the east, the Service Building would be then centrally located. I would recommend that the plans and specifications for any other contemplated buildings be examined very carefully regarding the structural features. because I believe that buildings in isolated communities housing as many people as are accommodated at this Colony should be absolutely fireproof not only for protective purposes, but to reduce the expense of maintenance and depreciation.

We commend this report as representing conditions, unfortunately more or less applicable to the building operations in many other institutions in the state, but in no other institution to such a serious extent. 42 BOARDS AND COMMISSIONS [Feb.

This commission believes that the increasing call for money to work out the further development of all state institutions demands radical change in the methods followed in building construction. The commission has given careful attention to the types of buildings constructed and the character of work performed within the different institutions, to determine if. it were possible to fix upon some standard style of architecture and some standard method of building construction which could be made applicable to most of the requirements of the commonwealth for its public buildings. In pursuing its investigation the commission has been very much im- pressed by the superior quality of work performed at the State Farm at Bridgewater, under the direction of one of the state’s most practical leaders in institution activities, Superintendent Blackstone of that institution. The commission believed that by the application of some of the business methods followed at Bridgewater, and that through a careful study by competent engineers, it would be possible to adapt to all the institutions of the state some of the best features of the buildings that have been constructed at the State Farm. Activities at some of the other state institutions where the use of concrete in building construction and where the employment of institution labor have led to a much less cost of buildings erected than had been quoted by reputable builders who were asked to compete, added still further weight to the confidence which the commission had in the possibilities of setting a standard for this important part of institution development. In working out some practical methods that may be followed, the commission again availed itself of the services of a skilled engineer, who has reported as follows upon the possibilities of standardizing building construction methods as they relate to institution requirements. This report is commended to the careful consideration of the legislature in connection with any plan that may be worked out for improved administration methods for the institutional work of the state.

Commission on Economy and Efficiency, Room 110, State House, Boston, Mass

Gentlemen:■— In accordance with your directions we have investigated the advisability of adopting a unit or sectional type of construction for state institutional buildings of all classes, and we herewith submit sketch plans and diagrams with descriptive matter and estimated costs of a type of construction which we feel is adaptable to the conditions which you require. 01 1914.1 HOUSE —No. I 43

Introduction In order to explain the various conclusions arrived at as embodied in our drawings and description, it will be necessary for us to review somewhat the conditions at present existing at the various state institutions with reference to buildings already erected, those under process of erection and contemplated projects. We find a great diversity of cost in state institutional buildings, also a very great difference in the size and character of rooms in institutions of the same character and type. For example, hospital buildings to house the same class of inmates differ greatly in cost at different institutions and even at the same institution. We find in consulting the recognized authorities on institutional buildings, particularly hospitals and prisons, that there has never yet been developed a general scheme of standardization with reference to the cubic contents of private rooms, wards or day rooms. Attempts have been made to secure statistical information for such standardization, but we have been unable to find instances where the result of the statistical study has been carried into effect. We also find no attempt made to standardize the structural materials entering into these buildings; particularly in this commonwealth there is a great variety of types and kinds of buildings. Some are constructed entirely of wood, others have masonry walls and wood floors and partitions, and a very few are entirely fireproof notably some of the buildings at Bridgewater State Farm. In arriving at the sizes we have adopted for rooms and wards and for a building unit, we have consulted many state documents, including the public documents of this commonwealth and the words of distinguished members of the medical profession, including Dr. S. S. Goldwater, Dr. John Allen Horner, Dr. George H. M. Rowe, Dr. C. Irving Fisher, Dr. Charles-Butler, Dr. H. B. Howard; and particularly with reference to prisons we have consulted the writ- ings of Dr. Charles R. Henderson and Capt. Hollis M. Blaokstone.

Factors Contributing to Difference in Cost of Buildings, One very important item contributing to the cost of state institutional buildings has been the attitude of the architect with reference to the architectural treatment and design of the buildings, Architects have in nearly every instance designed these institutions with great itress laid on the civic beauty idea; the buildings being arranged and designe 1 with the intention of constructing a grand and imposing group of buildup rather than attempting to design an economical and efficient plant. The great diversity in size and arr angement of buildings is also partly responsible for the great range in cost. The cubic contents of various rooms to be used for the same purpose will differ from 25 to 75 per cent, in various institutions ; and in some institutions the location of the buildings has contributed in a marked degree to the difference in cost, some being located on ground where normal foundations and grading are required, others being located where unusual and abnormal foundations and filling are necessary. An example of 44 BOARDS AND COMMISSIONS. Feb.

ohis can be seen at the North Grafton Colony. It is also true that the distance from railroad facilities has contributed its share to the difference in cost. The difference in materials, whether of wood construction, slow burning construction or fireproof, and the general water and sewerage systems, are other important factors contributing to variable costs. The mechanical equipment, including heating and ventilating apparatus and power plant layouts, including as they do all kinds of systems, direct and indirect, and the plenum or fan system, are also to be considered. One very important single item, contributing to a difference in cost, is the use of inmate labor. In some instances inmate labor is used to a very large extent, notably at Bridgewater; in other instances almost no inmate labor is available and in others very little. In developing the system of construction which we herewith recommend all of the above matters have received due consideration.

Considerations Governing the Design of a Unit Type op Construction. The first consideration is the architectural treatment. All architectural embellishment beyond that necessary to secure a substantial, properly-proportioned building can be neglected, the original function being utilitarian rather than artistic. Simplicity and efficiency should be the keynote in the design of all institutional buildings; in fact the very function of these buildings can best be carried into effect by keeping this fact in mind. The simplest layout and architectural treatment reduced deterioration and upkeep to a financial minimum. We have adopted a fireproof type of construction. This should be done for humanitarian reasons, if for no other; because we believe that the construction of wooden and partly fireproof frame buildings for the permanent housing of the state’s unfortunates is nothing short of criminal. The fireproof type of construction is also in the end the most economical, because, as above mentioned, upkeep and deterioration are negligible qualities. In our investigations we found the sizes of rooms ranging from 540 cubic feet to thirteen and fourteen hundred cubic feet, and a greater variation in the wards. We have adopted, however, after consulting the authorities above mentioned, as the proper cubic contents of a single room, 900 cubic feet, and of wards 800 cubic feet per patient. These are minimum capacities, and we have not considered any difference in capacity for adults, children or infants. The materials and method of construction we will discuss under separate headings. The chief consideration in the design of the unit type of construction has been the use of institution labor; in fact the intention has been, where the character of the inmates will permit, to use a maximum of such labor. In the use of institution labor we have not considered any ethical considerations, although we are convinced after investigating this matter that it is essentially desirable to design a type of building where the greatest amount of such labor can be used, inasmuch as medical authorities are agreed that this labor is of the greatest benefit to the inmates themselves, not only from the physical 1914.] HOUSE — No. 2137. 45 benefit of the exercise but also from the mental effect on the inmates who have a part in the building of the structures which they are to inhabit. It is con- ceded that participation in the building creates more contentment in the mind of the inmate. In the type of construction which we recommend we maintain that the interior arrangement, the daylighting and airing and the heating and ventilating and sanitary arrangements are of the highest type of efficiency; and are in line with examples of buildings constructed along similar lines and used for schoolhouse purposes in some of the largest cities in the country. In fact, schoolhouse construction, as one example, is now being developed into buildings of sawtooth roof design, one story in height, and without windows in the side walls, in such cities as Chicago, Illinois, and Rochester, New York. With reference to the mechanical and sanitary equipment of these buildings, including the heating, we have in each instance presumed that the building represents one of a group of several buildings, and that the heating and power plant is to be located in a separate building. There is nothing in the design, however, which precludes the possibility of installing a separate power plant and heating apparatus within the walls of each and every building. In developing the type of building which we recommend, it would seem necessary that provision be made for some central authority or building commission, composed of men who by education and experience are competent to handle building matters in the aggregate. The discussion of this matter, however, is not within the province of our investigations. We consider that the type of construction which we recommend can be divided into interior arrangements necessary to accommodate practically all the various types and classes of inmates now in state institutions. It is also apparent that laboratory buildings, auditoriums and other buildings of like character, can be constructed along the same lines that we recommend, but the units will necessarily I In submitting the plans and sketch s we do not claim that certain modifi- cations of the interior layout cannot be nade, but we merely show in a diagram- matic sense the fact that the proposed unit type of building is adaptable as we have stated above. We have not ati tempted to draw the complete plans of any one building, but have shown a typical floor plan of various buildings, more particularly those which call for the greatest outlay of money; it being easily understood that if thfe compile ited interiors can be well proportioned and economically arranged as regards idministrative details within the shell of the proposed building, the more simple arrangements can easily be obtained. We have not attempted to show in great detail the heating vents and ducts, or the plumbing and sanitary arrangements, except to note their position on the plan; neither have we gone into great detail regarding the structural features, the two sections giving all the information that is necessary in this regard.

Description of Unit Construction. In order to completely understand the description of the various plans wc adopt nomenclature. complete building will -’l- the following A as shown in drawing No. 1 will be called a UNIT; this unit to be divided in a SECTIONS 46 BOARDS AND COMMISSIONS [Feb. the sections sub-divided into two BAYS, and at each end of the building are airing balconies the length of one bay; making the total length of a unit 249 feet, the main dimension 30 feet 8 inches wide, and the overall dimension 38 feet 8 inches wide, each section being 31 feet by 30 feet and 8 inches, each bay 15 feet 6 inches by 30 feet and 8 inches, except the center section, which is spread 8 feet in order to provide administrative rooms and stairhall without interrupting the corridor. The height of the stories includes a basement 11 feet 4 inches from floor to floor, and three stores 12 feet 4 inches from floor to floor; giving a total for each completed unit of 7,470 square feet, or 396,700 cubic feet. These totals then will represent a complete unit of any group of buildings, whether asylums, hospitals, almshouses or any correctional institution. Drawing No. 1 shows a plan of a typical unit, without interior sub-divisions. We propose to construct the walls and floors and roof of each unit of poured concrete, reinforced where necessary for structural purposes. We recommend that a collapsible or elastic system of steel or wood forms be constructed for two entire sections, including two side and one end wall and the floors and roof. With this equipment a unit may be poured with the greatest economy of time, labor and material. We estimate for the initial cost of a set of forms as above described, made of sheet steel and angle irons, rivetted in small sections, with the necessary clips and ties, inner and outer angle pieces, and special forms for beams, in round figures $4,000. If built of wood of a collapsible nature the forms would cost in round figures 15,400. These forms can be used over and over again, and may be knocked down and shipped from point to point wherever buildings are to be constructed. If on account of the great number of projects which the state is called upon to erect it is necessary to duplicate the forms the cost is not prohibitive, the outlay being a very small percentage of the equipment necessary for the enormous amount of building the state is called upon to do. By using these forms the walls and floor and roof of the unit can be constructed entirely by inmates of the various institutions where the buildings are being erected. The windows and outside door jambs will be set into the forms, and the concrete poured around as the walls progress. In placing the interior partitions as in drawing No. 2, which shows a typical floor plan of an asylum building, wg have considered two methods of construction. The first method contemplates the continued use of institution labor. Light angle irons are bolted to floor and ceiling, and into these are set oast slabs four inches thick of reinforced concrete, winch are cast on the ground and then set in Portland cement mortar for all partitions. This obviates the necessity of plastering, which requires more highly skilled labor; the only plastering in this building being in the center bay, the ceiling of the top floor and the ceiling of the corridors. The second method of partition construction is to erect high-rib expanded metal partitions, and plaster both side Specifications. Foundation, floors and walls to be of concrete, plain and reinforced, water- proofed; roof, reinforced concrete covered with 5-ply pitch and gravel construction. Window frames and sash and trim, wood, with weather strips and 1914.] HOUSE Xo. 2137 47 double-hung sash. Doors and frames of wood. Stairs, reinforced concrete. Plaster, where used, 3-coat hard plaster, finished with sand finish. Finished floors, terrazzo, turned up for sanitary base. Stair-treads and risers and hand- rail also of terrazzo. Outside walls to be damp-proofed during construction; inside walls and ceilings to be tinted with 3-coat work. Inside woodwork stained and varnished, three coats; outside woodwork painted three coats, lead and oil. Building to be furnished with bronze wire wood-frames fly screens, also screendoors for exterior doors. The mechanical and heating equipment to consist of electric waring for lighting system; vacuum cleaner system; heating and exhaust fans, with motors, air washers and motor, and galvanized iron ventilating ducts and exhausts. The plumbing to be of first-class porcelain enameled material; the stalls to have slate partitions and backs. Both shower and tub baths are to be used. The heating ducts in a building as shown on drawing No. 2 are in the ceilings of the corridors, the risers taken up in the clothes rooms. In types of buildings where a large portion of the building is devoted to wards and day rooms, the heating ducts are brought up through closets and along inside walls. The heating plant delivers steam to heating chambers in the basement of the unit, and the heat is there blown by fans into the reservoir ducts, branch- ing into the rooms at the ceiling line; and the cold and foul air is drawn from the floor of the room by the exhaust fan in the reservoir duct in the top of the building, and there exhausted to the open air. The advantages of this system are the concentration of the heating apparatus at one point, the elimination of all steam piping throughout the building except in the blower room, and the ventilation of air changes which are pos- itively given. We have not contemplated any re-circulation of air, although we have provided for an air-washer before the air is distributedto the building.

Elasticity of this Method of Construction While we have considered a unit as shown in drawing No. 1, there is no reason, structural or otherwise, why the units cannot be extended as shown in diagrams A, B and C, diagram A representing a complete unit; diagram B an extension of ells, and diagram C a completed quadrangle. We do not recommend that such buildings as diagram B and C be constructed, but merely give this as an illustration of the elasticity of this method.

Description of Plan Before going into the matter of costs , and comparisons with other types of building, we would respectfully call y iur attention to the drawings. (See drawings at end of report.) Drawing No. 1, as stated above, shov the blank walls of a complete unit, Drawing No. 2 shows a typical floor lay •out for an insane asylum or a private room hospital. Drawing No. 3 shows a typical adrr inistration building, suitable for all classes of institutions. Drawing No. 4 shows a reformatory building, and shows the greatest amount 48 BOARDS AND COMMISSIONS. [Feb.

of cross-wall or partition construction that will probably be encountered in any institutional building. Drawing No. 5 shows a woman’s custodial building, along the lines contemplated in the new building at the Boston State Hospital. Drawing No. 6 shows an almshouse along the hues of the new almshouse building at Bridgewater. Drawing No. 7 shows a hospital building for a boys’ school, along the lines of the one contemplated at Wrentham. Drawing No. 8 shows two sections, showing the adaptability of this type of construction to either cow barns or horse stables. Drawings Nos. 9 and 10 are cross-sections of the unit building, We have also furnished a pen and ink perspective sketch of a complete unit. It seemed unnecessary to multiply the number of drawings, inasmuch as it is plainly apparent from those shown that a section 31 feet by 30 feet 8 inches is a -workable unit for all requirements. We have not deemed it necessary to show every kind of room necessary in each building, but have taken for examples those floors which require the greatest number of sub-divisions, because in those buildings or floors requiring few sub-divisions the problem of building a unit such as we have illustrated is exceedingly simple. In computing the cost of a unit building we have used the dormitory building as shown on drawing No. 4, this building embodying the greatest number of cross-walls and partitions; in other words, the most expensive building we have to build. In arriving at the cost of the forms, an item of $BOO.OO, we have figured 20% of the cost of the steel forms allowing that they would be used five times in any one year. We have consequently estimated the cost of the unit above described as follows:

$5O 00 150 00 Exc 881 40 Walls 1,881 00 B 125 00 800 00

Concrete w 5,865 00

Cc 300 00

C irs ’3 00

( 1,791 00 Basement 339 60 Window stools 25 00 Steel reinforoei 3,646 50 1,527 20 Nails and hard 1,275 00

weigl •ords 608 22 1914.] HOUSE No, 2137 49

Window sash and frames and finish, 3,052 00 Doors and frames and finish, . 456 00 Basement doors. 150 00 Outside doors, frames and entran 800 00 Plastering, .... 806 40 Painting, lead and oil 997 00 Tinting, 2,032 80 Varnish, 147 00 Plumbing, with slate stai 7,600 00 Window guards, 371 00 work, Stair 1,200 00 Asphalt roofing, 540 28 Gravel stop, . 34 92 Carpenter labor, doors, 200 00 Carpenter labor, window 654 00 Washing down and cleanii: ig up, 250 00

Watchman 300 00 Miscellaneous teaming 350 00 Miscellaneous labor, 500 00 Superintendence, 1.000 00

Weather strips. 545 00 Oakum packing, window 436 00 Concrete partitions, 4,999 00 Hung ceilings, 1,060 00 Cinder filling, 358 20 Terrazzo floors 5,348 00 Entrance porch and steps 180 00 Electric wiring and fixtur 3,000 00 Complete heating plant, 15,000 00 Vacuum cleaner 1,100 00 Fly screens, . 606 00 Damp proofin 309 00

Liability insurance 500 00

Contractor’s profit, 8,612 05 Engineer’s fees, 6%, ,883

Grand tot 898,616

This brings the cost of the building at $866.00 per inmate, there being 114 rooms for patients in this building. If the high-rib and plaster construction is used there will be a reduction from this cost of $4036.00, making a cost of $94,580.52. It should be remembered that this is the most expensive construction contemplated under the unit system, providing a fireproof building, and the prices are market prices for contractors’ services such as would be obtained in open bidding if plans and specifications were completed and issued for estimates. 50 BOARDS AND COMMISSIONS. [Feb.

Comparative Costs and Sizes, We submit a table of comparisons; showing the cost per inmate, and the cubic foot of building per inmate. These figures are the result of our own estimates in case of the unit construction, and the submitted bids on the Boston State Hospital and the Wrentham School, and the cost quoted by Captain Hollis M. Blackstone of Bridgewater. It will be noted in the case of the Boston State Hospital and the Wrentham School building that our cost per patient is less, and our cubic feet per patient is less than proposed new construction. In the case of the Bridgewater almshouse we show 23 feet less cubic contents per patient, but are away above in cost per cubic foot and cost per patient. I think this is an important part of the investigation which your commission desires to show. The great difference in cost represents the item of institution labor. At Bridgewater, Captain Blackstone recovers his stone and crushes the same, and also secures and hauls his sand, power already being developed at the plant for his crusher, and he uses farm teams for hauling. He manufactures his lumber, including doors and window frames and special sash, on the premises, with institutionlabor and power developed at the central power plant. His forms are erected and removed, and his concrete mixed and placed, by institution labor. And in no case has he been obliged to hire more than 10% of the labor in any of the later buildings which he has built. Then, too, no overhead expense is chargeable, the superintendent of the building construction assuming his duties in addition to other duties which make his office a necessity. Even the terrazzo floors, the painting and decorating, por- tions of the heating and plumbing and electric light wiring, are done by institution labor. The only difference in the construction of the unit building and the Bridgewater almshouse is in the roof, the Bridgewater almshouse having a wood-timbered roof. In comparison, however, with the Boston State Hospital, and the Wrentham School, a greater difference exists, the latter buildings being of brick and terra cotta construction with wood and slate roof. It is readily seen that the use of institution labor will greatly reduce the expense to the commonwealth of constructing the unit building; how great a reduction it is impossible for us to arrive at, inasmuch as no figures have been kept at any of the state institutions showing the value of such labor. We believe, therefore, that adopting this type of construction, which has so great a proportion of construction adapted to the employment of institution labor, will mean a tremendous saving in construction costs. 1914.] HOUSE — No. 2137. 51

Num- r Cubic Cubic Square . _ ' rCost ber of t,o Feet Feet. Feet. | ' Pa- per Pa- x ent tients. - tient.

Almshouse, unit type, 396,700 7,470 $81,461 12 156 $522 18 2,543 Bridgewater almshouse, 523,496 13,986 60,000 00 204 294 12 2,566

Woman’s custodial building, unit type, . 396,700 7,470 89,500 00 102 877 45 3,889 Woman’s custodial building, proposed, 515,284 10,516 121,000 00 102 1,186 60 5,052

Hospital for boys and girls, unit type, . 214,332 4,044 46,443 00 64 725 67 3,349

Wrentham boys’ and girls’ hospital, . 192,678 4,999 60,000 00 45 1,333 00 4,280

It will be seen from the foregoing table that in the case of the almshouse the cubic space per patient is practically the same as the unit type, but in the case of the Boston State Hospital and the Wrentham School a great difference in favor of the unit tsq>e or standardized type is shown. It also shows that a fireproof building can be built for less money than a slow burning building. In the Boston State Hospital and Wrentham School it will be practically impossible to use institution labor, in view of the fact that all of the construction requires labor of the very highest and most expensive type. We trust that the foregoing will demonstrate beyond all doubt the prac- ticability of adopting the unit type of construction for state institutional buildings.

Summary We trust that the investigations we have made and the plans and descriptions have covered all the ground which you contemplated in your instructions to us. We have been particularly frank in discussing this problem, and in each case have quoted prices giving a contractor the benefit of the doubt. Very respectfully yours, Samuel M. Green Company.

THE IMMEDIATE NEED The amount of money required in 1914 for the maintenance of the state institutions involved in this plan of reorganization will reach the sum of $9,000,000.00. For continued development along present lines the annual call for new equipment will probably exceed $2,000,000.00 additional. In addition to this the following table shows that for the various institutions now established there has been created a debt by past appropriations, almost universally ignored in previous estimates, which represents an annual burden upon the state of over $200,000.00 for sinking fund requirements, and for annual interest charges for 1914 a further call for over $325,000.00. 52 BOARDS AND COMMISSIONS. [Feb,

DpKt Sinking Valuation, In ’ Name. Net Debt . Interest, Bonds,

Hospital, - Boston State ... $1,958,030 00 $280,933 60 81,677,066 40 $67,270 00 Danvers State Hospital, . . $1,708,088 32 232,400 00 120,747 87 111,652 13 8,040 80 Foxborough State Hospital, . . 223,897 52 130,000 00 31,964 20 98,035 80 5,000 00

- Gardner State Colony, ... 462,550 00 235,261 65 227,298 35 16,189 25

- Grafton State Hospital, ... 200,000 00 40,000 00 160,000 00 6,400 00

Industrial School for Boys, . , - 126,000 00 17,273 46 108,726 54 4,197 50 Lyman School for Boys, , . 241,527 19 47,000 00 7,195 05 39,804 95 1,645 00

Massachusetts Hospital School, . - 300,000 00 131,648 26 168,351 74 10,600 00 MassachusettsSchool for the Feeble- 344,223 87 405,000 00 155,975 80 249,024 20 15,150 00 minded. MassachusettsReformatory, , . 1,333,066 85 22,700 00 13,682 93 9,017 07 732 28 Northampton State Hospital, . 663,226 59 179,000 00 91,475 80 87,524 20 6,362 15 Reformatory-foe Women, , . 481,253 98 9,000 00 5,425 17 3,574 83 290 33 StateFarm 754,522 31 478,500 00 141,673 75 336,826 25 17,003 33 State Industrial School for Girls, . 176,497 76 31,350 00 4,799 11 26,550 89 1,097 25 State Infirmary 848,494 22 341,300 00 101,768 14 239,541 86 12,842 07

Taunton State Hospital, . 715,228 73 245,600 00 123,486 88 122,113 12 8,489 09

Westborough State Hospital, . 678,102 60 449,300 00 192,382 36 250,917 64 15,581 31 Worcester State Asylum, . 228,600 00 443,000 00 178,247 00 264,763 00 15,505 00 Worcester State Hospital, . . 1,364,069 13 168,000 00 71,391 17 86,608 83 5,406 64

- Wrentham State School, ... 245,800 00 35,597 41 210,202 69 8,355 50

$9,750,799 06 $6,464,500 00 $1,980,909 61 $4,483,590 39 $221,057 50

Debt In- S" 11™* . . InT st Name. Valuation. Net Debt. | ££ ' Bonds. I

- Monson State Hospital, ... $666,450 00 $312,330 46 $354,119 54 $21,973 50

Rutland State Sanatorium, . - 450,500 00 301,532 77 148,967 23 14,905 00

Lakeville State Sanatorium, . - 105,000 00 ]

North Reading State Sanatorium, . - 105,000 00 } 54,777 94 260,222 06 11,025 00

Westfield State Sanatorium, . - 105,000 00 J Medfield State Asylum, 119,352 27 1 1,439,800 00 943,668 20 526,131 80 51,443 00 $119,352 27 $2,901,750 00 $1,612,30937 $1,289,440 63 $99,346 50

i 1893.

In the administration of the great institutions, involving the large sums of money above noted, it is agreed that many conflict- ing bodies are now inefficiently working. In the suggested reorgan- 1914.] HOUSE No. 2137 53 izatiou by this commission it will be possible to provide such a centralized oversight as will work out the entire problem as one great problem, with all of its different phases properly co-ordinated, and with genuine co-operation between all of the factors employed. Conflict of authority, duplication of service, wrong classification of patients and complicated conditions within single institutions are all referred to as large parts of the present serious questions met by administrators in different departments of work; these are not the only considerations. The Prison Commissioner in his report of this year makes it clear that his time is given almost entirely to detail work and minor labors which keep him from such service to the prisoners of the commonwealth and such relief of their conditions as should come from Iris position. Reports of practically every board of trustees call attention to the difficulties associated with the present complex system of control in these institutions. The time has come when the whole question of the relation of county and municipal institutions performing any particular service similar to that performed by state institutions must be taken into account in any plan for treat- ing all the wards of the state. It is clear to this commission that with such a central authority as is suggested, it will be possible to make available a large amount of room and institution equipment not now of any real value, and in many cases not used at all in the present work of county institutions. This commission further believes that it will be possible to so develop the standardizing and distribution of manufactures, the employment of inmate labor for the good of the inmate himself and the relief of his family, the development of standard building construction, and co-operation in developing all institution activities through a centralized board, as to bring large economies in the administration of this branch of the public service, which in 1913 called from the treasury more money than the entire amount raised in the state tax. Before the legislature of this year there are pending many calls for new buildings, new equipment, increased appropriations for maintenance and many different schemes for changes, which should all be dependent upon the position taken by the legislature in connection with a proper plan for the reorganization of these many different boards and Commissions. 54 BOARDS AND COMMISSIONS. Feb.

Under the conditions, this commission believes that every kind of development of public institutions for 1914 should be held within the narrowest possible bounds. No further development should be authorized that would continue such conditions as are noted at Grafton in building construction, or such methods as have been referred to in accounting and administration applicable to practically every state institution. This commission further believes that if appropriations for further development are withheld this year, it will be possible for a centralized commission to show how, by acquiring certain county equipment, by economizing many factors in the present state equipment, and by consolidation of the work of different departments, there may be made available in existing buildings, in existing equipment and in existing organization, all that will be necessary for the carrying out of present needs and future development for a number of years, without the expenditure of any considerable sums of money by the commonwealth for new buildings or new equipment.

COMMISSION ON ECONOMY AND EFFICIENCY

JOHN N. COLE, Chairman. FRANCIS X. TYRRELL. FRANK H. POPE. 4-

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Ciic Commontoealtf) of sgassacjnisetts.

In the Year One Thousand Nine Hundred and Fourteen.

AN ACT TO CREATE A COMMISSION OF PUBLIC INSTITUTIONS Be it enacted, etc., as follows 1 Section 1. There is hereby created a commission of public institutions, 2 which shall be constituted the state agency for the care of all wards of the 3 commonwealth, dependent, delinquent, criminal, insane, correctional, 4 and otherwise. The commission shall consist of five persons, residents of 5 the commonwealth, who shallbe appointed by the governor, with the advice 6 and consent of the council. The terms of office of the persons first appointed 7 shall be so arranged that the term of one member, to be designated chairman, 8 shall expire in five years, one in four years, one in three years, one in two years, 9 and one in one year from the first day of July, nineteen hundred and fourteen. 10 Annually thereafter, the governor, with the advice and consent of the council, 11 shall appoint a member to serve for a term of five years, as the term of any 12 member appointed by him shall expire. The governor shall designate the 13 chairman, and the chairman and other members shall each receive such 14 annual salaries as shall be fixed by the governor and council. An}' vacancy 15 for unexpired terms shall be filled by the governor, with the advice and con- -16 sent of the council, and upon the expiration, or other determination of the 17 term of the chairman, the governor shall designate a member to serve as 18 chairman. In all cases, a member shall continue to serve until his successor 19 is appointed and qualified. Members of the commission shall devote such 20 time as may be necessary to the work of the commission, and any member 21 may be removed by the governor, with the advice and consent of the council. 22 Members shall be allowed necessary travelling expenses.

1 Section 2. The commission shall have exclusive control of general 2 policies affecting the' concern and care of all wards of the commonwealth, 3 dependent, delinquent, criminal, insane, correctional, and otherwise. The 4 commission shall also have authority to supervise and control all matters 5 connected with the administration of such policies, including all institutions 6 and activities within the scope of its jurisdiction. It shall arrange and pro- -7 vide such uniformity of methods and classification of agencies as -will promote 8 in the best possible manner the betterment of inmate welfare and as will 9 insure an efficient administration of the several institutions and the several 1914.] HOUSE No. 2137 61

10 activities under its control. It shall make such rules and regulations for thf 11 execution of its powers as shall be consistent with the purpose of this act.

1 Section 3. For the purpose of this act, there shall vest in the commission 2 all the rights, powers and duties now pertaining to and vested in the State 3 Board of Charity, State Board of Insanity and Prison Commission; in like 4 manner shall so vest all the rights, powers and duties now pertaining to and 5 vested in the boards of trustees of the following: Boston State Hospital; 6 Danvers State Hospital; Foxborough State Hospital and Norfolk State 7 Hospital; Gardner State Colony; Massachusetts School for the Feeble- -8 Minded; Medfield State Asylum; Monson State Hospital; Northampton 9 State Hospital; Taunton State Hospital; Westborough State Hospital; 10 Worcester State Hospital and Worcester State Asylum; Wrentham State 11 School; Hospitals for Consumptives; Massachusetts Hospital School; Mas- -12 sachusetts Training Schools; State Farm and State Infirmary. Likewise 13 there shall vest in the commission all the rights, powers and duties now per- il taining to and vested in the Massachusetts Commission for the Blind, the 15 Commission on Probation and the several parole boards, including all rights, 16 powers and duties now pertaining to and vested in any and all state agencies, 17 in addition to and otherwise than those mentioned, providing for the concern 18 and care of all wards of the commonwealth. There shall also be transferred 19 to and vested in the commission the right to expend any unexpended funds 20 heretofore appropriated to be expended by the boards, commissions and 21 agencies hereinbefore mentioned.

1 Section 4. The terms of office of the present members of the State Board 2 of Charity, the State Board of Insanity and the Prison Commission, and of 3 the various boards of trustees and of other agencies, specifically or otherwise 4 referred to in the previous section, shall expire on July 1, 1914; said boards, 5 commissions and agencies shall then cease to exist.

1 Section 6. Subject to the approval of the governor, the commission 2 shall appoint a director of public institutions to serve for an indefinite term. 3 The salary of this official shall be determined, and removal from office shall 4be effected in like manner. The director of public institutions shall be the 5 chief administrative office of the commission. To him the commission may 6 delegate such powers and duties and in such degree as may be deemed by it 7 compatible with the proper execution of its general policies; such powers and 8 duties shall among other things be concerned with the direction and adminis- -9 tration of the several institutions and activities embraced within the juris- 10 diction of the commission, including all matters involved in the custody, care 11 and treatment of patients, inmat s, prisoners and others, together with 12 control of the business affairs of th commission and the several institutions 13 embraced within its jurisdiction; provided, however, that no buildings or 14 works shall be constructed or materially altered; no general classification of 15 inmates of institutions shall be made; no request for appropriation shall be 16 submitted, and no general plans shall be adopted by the director, until such 02 BOARDS AND COMMISSION’S. [Feb.

17 matters have been submitted to the commission for its consideration and 18 approval. The director shall be directly responsible to the commission for 19 the administration of such policies and courses of action as the commission 20 may from time to time adopt, and he shall also be responsible to the commis- -21 sion for the proper execution of any and all powers and duties such as may be 22 vested in and imposed upon him by the commission. 23 The director shall from time to time and annually make a report to the 24 commission showing the work performed under his control together with 25 such facts and suggestions or recommendations as may seem to him necessary 26 and advisable.

1 Section 6. Subject to the approval of the commission, the director shall 2 appoint executive secretaries, in number not exceeding four, whose terms of 3 office and salaries shall be fixed by the director with the approval of the 4 commission, and who may be removed from office in like manner. The 5 executive secretaries shall be employed under the general control and direc- -6 tion of the director; said secretaries shall have such authority in theirrespec- 7 tive divisions as the director may see fit to impose, and over such institutions 8 as the director may designate. They shall be responsible to the director for 9 proper administration of all matters under their immediate care; said secre- -10 taries shall, except as where otherwise provided, direct and advise all institu- -11 tional officials and others within their divisions, relative to affairs of adminis- -12 trationand proper methods of procedure.

1 Section 7. Subject to approval of the commission, the director shall 2 appoint a business agent, whose salary and term of office shall be determined 3 by the director, with the approval of the commission. Removal from office 4 may be made in like manner. The business agent shall, subject to the direc- -5 tor, devise and install in the offices of the commission and in the institutions 6 uniform and improved methods of purchasing and of storage; he shallprovide 7 for the proper distribution of equipment, materials, supplies, and other 8 goods; he shall likewise provide uniform systems of accounting and reporting 9 in all items pertaining to departmental and institutional business; he shall 10 establish improved methods for the conduct of institutional farms and for 11 the utilization of farm products. He shall likewise supervise, control and 12 direct as may be required, the construction of buildings, and shall maintain 13 an efficient standard of repair and physical upkeep of all properties under the 14 control of the commission. In addition, the business agent shall supervise, 15 conduct and direct such other activities as may be assigned him by the direc- -16 tor. To carry out the purpose of this act, the business agent shall, subject 17 to the approval of the director, appoint such assistants as may be necessary, 18 including a purchasing agent for departmental and institutional needs.

1 Section 8. The governor, with the advice and consent of the council, 2 shall appoint a board of visitors for each institution under control of the 3 commission. Said boards shall each consist of three members. The terms of 1914.] HOUSE - No. 2137. 63

4 office of the persons first appointed shall be so arranged that the term of one 5 member shall expire in three years, one in two years, and one in one year 6 from the first day of July, nineteen hundred and fourteen. Annually there- -7 after, the governor, with the advice and consent of the council, shall appoint 8 a member to serve for a term of three years, as the term of any member 9 appointed by him shall expire. Members of boards shall receive no com- -10 pensation, but such allowance shall be made for necessary travelling expenses 11 as shall be approved of by the governor and council. Boards of visitors 12 shall be empowered to investigate all matters relating to medical, correctional 13 and custodial affairs affecting inmates of the several institutions under con- -14 trol of the commission. Said boards shall be empowered to hear complaints 15 of all inmates and investigate all charges made relative to matters within 16 the scope of their jurisdiction, and each board may from time to time and at 17 its discretion report to the director, commission, or to the governor and 18 council, direct. In addition the several boards shall make annual reports, 19 which reports, together with the various reports of the director, shall be 20 collected, arranged and published as integral parts of the annual report of 21 the commission.

1 Section 9. Annually on or before the first day of October next preceding 2 the legislative session in which it is intended to request the consideration 3 thereof, the commission of public institutions shall submit to the Commission 4 on Economy and Efficiency detailed estimates, including necessary plans, 5 specifications and the like, for any and all increases pertaining to items of 6 maintenance; and full information relating to any and all matters for which 7 it is intended to petition the general court for special appropriations.

1 Section 10. The commission shall have an office in the city of Boston, 2 where shall be kept such maps, plans and other documents as may be neces- -3 sary for the proper execution of the work of the commission. The commission 4 may authorize the appointment of such experts, clerks and assistants, as 5 may be necessary and proper for the administration of the work of the com- 6 mission.

1 Section 11. All acts and parts if acts inconsistent herewith are hereby 2 repealed.

1 Section 12. This act shall take effect on July first, nineteen hundred 2 and fourteer