Direct Service Cutbacks: 1974-1978
Child Health Stations
Child Health Stations provide such free preven-
tive services as new-born infant care; well-child
evaluation; growth and evaluation assessment;
child health assurance programs (CHAP); im-
munizations; screening for treatable disorders;
parent counseling and education; and women,
infant, and children (WIC) supplemental feeding
programs. 22 Child Health Stations which have
been upgraded to Pediatric Treatment Centers
also provide primary medical care for sick chil-
dren up to age twelve (8).
During the period between July 1, 1974 and
July 1, 1976, 20 of the original 78 Child Health
Stations and Pediatric Treatment Centers were
closed, a 26% drop. Between FY 73-74 and FY
76-77, there has been approximately an 8% re-
duction in visits to Child Health Stations. In
the same period, there has been a 10% reduc-
tion in physician hours, a 13% reduction in public
health nursing hours and an 18% drop in public
health assistant hours.
Dental Services
Dental services which had included examina-
tion, treatment, prevention and education, have
been cut significantly since 1974. At that time,
there were 27 clinics situated in Health Centers
and 164 in schools. In 1978, there were only
18 Health Center clinics and 105 school clinics
remaining, about a 33% drop in both instances.
Between FY 74-75 and FY 76-77, direct clinic
expenditures were reduced by 45%. Dental ser-
vices suffered a 47% reduction in annual dentist
hours, a 56% reduction in annual dental hygienist
hours and a 46% drop in annual dental assistant
hours.
Chest Clinics
The Department of Health operates Chest
Clinics in both its own District Health Centers
and in municipal hospitals. Health Center Clinics
provide screening exams, x-rays, sputum induc-
tion, case finding and treatment for patients with
tuberculosis and associated diseases (8). Between
1974 and 1978, the number of Chest Clinics in
District Services have been cut by 35%, from 27
in 1974 to 17 in 1978.
Eye Clinics
Department of Health Eye Clinics primarily pro-
vide screening for eye pathology and correc-
tion of vision problems, usually refractive er-
rors. The program is for children only. There is
little follow-up as patients are referred to lo-
cal practitioners. The clinics are staffed by De-
partment optometrists and opthamologists (8).
Between 1974 and 1978, 12 of an original
22 Eye Clinics were closed, a 55% reduction.
Annual hours for physicians and public health
assistants have also been reduced by 50%, as
have both volume of service and costs ($206,000
in 1973-74 to $104,843 in 1976-77). The com-
plete closure of all DOH Eye Clinics has been pro-
posed and considered at various times since the
onset of the fiscal crisis.
Social Hygiene Clinics
DOH operated Venereal Disease Clinics
throughout the city, providing free care for screen-
ing, contact investigation and case finding. The
program involves intake, laboratory, physician
diagnosis and treatment (8).
Between FY 73-74 and FY 76-77, two clinics
were closed, physician hours were cut by 20%,
public health assistants' hours were cut by 25%
and public health nurses' hours were cut by
12%. However, total patient visits increased by
3% during this period.
Public Health, Social Work,
Nutrition and Education
Since 1974 these three programs have been
virtually eliminated. Only a small core of these
health professionals is still retained in the Central
Office of District Health Services to lend support
to the few remaining district programs. Nutrition
counseling to low income and disadvantaged
mothers and the elderly has been drastically
curtailed as have such health education activi-
ties as consumer education, participation in health
planning and health consumer advisory commit-
tees, school health education programs, hos-
pital staff and patients' education programs, ma-
ternal and child health and family planning pro-
grams. By 1975, there were no social workers
left at decentralized service facilities, and referrals