This section is from the "The Subvention In The State Finances Of Pennsylvania" book, by Frederic B. Garver.
Subventions for charity from the Pennsylvania state treasury at the present time are paid in part to the counties and in part to a large number of privately managed eleemosynary institutions and voluntary organizations. The counties received, in 1916, $697,457 for the partial maintenance of the asylums for the insane that many of them have established. *1 In the same year privately managed hospitals and other institutions for the treatment of the sick received $2,268,497. *2 and privately managed schools for the blind, for the deaf and dumb, and for feeble-minded children were paid $499,531. *3 A reformatory for children under partial private control received $175,144, *4 and an asylum for the insane, under similar management, received $125,246. In addition to these amounts $422,613 was paid as subsidies to homes for the aged, orphanages, and miscellaneous organizations engaged in some form of charitable work. *5 In brief the. state paid $3,491,031 to privately managed institutions and $697,457, to the counties or a total of $4,188,488.
The true importance and magnitude of these payments is better appreciated when compared with other items of state expenditure in the same year. The subvention to common schools amounted in 1916 to $8,663,175, and the grants for all educational purposes totaled $11,247,884. *6 Expenditure for highway construction and maintenance was $3,732,386, and for the department of health $2,263,512, *7 while the total of all payments from the state treasury was $35,489,553. *8 Subventions to privately managed hospitals exceeded in amount the payments from the state treasury for any other specific service, the support of the common schools and the construction and maintenance of highways excepted.
1 Aud. Gen. Report (1916), pp. 635-639.
2 Idem, pp. 639-650.
3 Idem, p. 651.
4 Idem, p. 635.
5 These organizations included societies for the prevention of cruelty to children, children's aid societies, anti-tuberculosis leagues, organizations for reclaiming and protecting delinquent children, and for the assistance of women and girls who have been guilty of infraction of certain moral laws.
6 Table III, Appendix.
7 Aud. Gen. Report (1916), p. 599.
8 Idem, table following p. 679.
Lavish expenditure for subventions to private charitable institutions is, practically speaking, a product of the last twenty-five years. In 1891 the state paid only $661,197 for all such subventions. The increase, which amounts to 428 per cent, has been due chiefly to the remarkable and growing liberality of the legislature toward local hospitals. Subventions to these institutions in 1914 exceeded those of 1891 by more than 1500 per cent, and those of 1892 by over 940 per cent. On the other hand, grants to private institutions for training and caring for the blind, deaf mutes, the feeble minded, and the insane only increased from $374,681 to$538,490 during the period 1891 to 1914, and those to reformatories from $65,000 to $150,942. Clearly, then, the great expansion of the subvention for charity cannot be charged to these latter two classes of grants. Two other types of subvention are jointly responsible with the appropriations to hospitals for the increase. The grant in aid to county asylums for the insane first made its appearance in the financial reports in 1896 as a very moderate payment of $75,527, but by 1914 it was more than ten times as large. In the second place, the subvention to orphanages, homes for the aged, and to miscellaneous organizations increased from $35,107 in 1891 to $381,655 in 1914, a gain of over 900 per cent.
The number of institutions receiving state aid has, of course, increased very greatly. In 1881 grants were made to seven hospitals and ten years later to thirty-six. *9 In 1914 the Auditor General reports a list of 155 hospitals, including those connected with medical colleges, as recipients of state aid. In 1916 the number was 161. The number of homes and miscellaneous organizations has also increased rapidly in recent years. In 1896 only 36 homes, orphanages and miscellaneous organizations received aid. In 1914, one hundred and nine, and in 1916 one hundred and seven homes and orphanages and miscellaneous organizations appear in the lists of the Auditor General.
9 Roberts, J. B. State Appropriations to Hospitals not under State Control. What Pennsylvania is Doing, Pennsylvania Medical Journal, Vol. XIII (1910), p. 253.
The results of a comparison of present-day expenditures with those of the years 1874 to 1888 are still more striking. In the earlier year the schools for the blind, deaf-mutes, and the feeble-minded received $118,139; reformatories $135,500; an asylum for the insane $52,250; hospitals $127,500; orphanages $12,500; and miscellaneous organizations $1,500; or a total of $447,389.10 But, by 1878, owing to the lack of revenue and the influence of the new constitution, the total payments for subventions to charitable institutions had been measurably reduced and amounted to only $136,822. In 1879 the total was $155,580, and in 1880, $459,471. At no time between 1874 and 1888 did the appropriations to privately managed hospitals exceed $100,000. Orphanages, not including those for soldiers' orphans, never received more than $22,500 in any one year from 1874 to 1890, while payments to homes for the aged and to miscellaneous organizations were practically negligible. During the years 1875 to 1890 the largest part of the subventions for charity was paid to the institutions for defectives.
The prodigious growth of subventions for charity in recent years has been due to many forces, some of which are most obscure in their nature and indirect in their operation. First among these forces is the tendency toward the socialization of many services previously regarded as outside the proper sphere of governmental action. Elaboration of public education, the extension of facilities for public recreation, improvements in sanitation, and the development of highly specialized institutions for the care and treatment of defectives are all evidences of this tendency. Now the increase of public expenditure for these purposes is practically nationwide. But in a large majority of the states the extension of the scope of eleemosynary institutions has been accomplished under state ownership and management. In Pennsylvania, however, the state has pursued a dual policy: It has built large and costly institutions directly administered by its own officers and at the same time it has paid liberal subsidies to privately managed institutions and organizations providing the same services. *11
10 The classification of the Auditor General has not been preserved. Homes for the feeble-minded and for the blind have been excluded from the totals given in the text of his report as have also homes for defectives.
11 For a brief statement of the extent of subventions to private charitable institutions in other states see an article by Mr. Alexander Fleisher, State Money and Privately Managed Charities, The Survey, Vol. XXXIII (1914), pp. 110-112.