Direct Service Cutbacks: 1974-1978

could be handled only by telephone through the as working paper and athletic team exams (8).
remaining staff in the Central Office. Between 1974 and 1976, School Health Ser-
General Immunization vices have been significantly reduced. Some
Between 1974 and 1978, General Immuniza- 50,000 physician hours have been eliminated
tion Clinics in District Health Centers were cut from an original 80,000 physician hours annually,
by 50%, from 10 in 1974 to five as of Spring a 65% drop. Both fourth grade and eighth grade
examinations were eliminated. Pediatric nurse
1978. These clinics administer shots for trave-
associates were introduced into the program to
lers, anti-rabies and influenza shots. (Preschool
partially offset the reduction in physician hours.
immunizations are provided in the Child Health
This represents a significant change in the program
Stations and in the School Health Programs.)
and a marked reduction in cost.
Sickle Cell Testing
Prison Health
Sickle Cell Testing Clinics offer screening for
the sickle cell trait among Black People, but Prison Health services witnessed a 25% reduc-
offer no follow-up of genetic counseling ser- tion in FY 74-75 which resulted in a loss of 7
vices. Since 1974, Sickle Cell Testing Services physicians, 52 nurses (mostly RNs), as well as
in District Health Centers have been cut from a 47% drop in dentists and a 50% reduction in
six to four. dental hours. One third of the pharmacists were
Lead Poisoning Clinics dropped and all the program analysts at the
Two Lead Poisoning Screening Services have Prison Health Services Central Office were elimina-
been eliminated from District Services Health ted. Mental Health Services were perhaps cut back
Centers since 1974, reducing the number from the most, losing 30% of the part-time psychiatrists,
seven to five. 50% of the social workers (including the psych-
Tropical Disease Clinics iatric aftercare program, and 30% of the psych-
The Tropical Disease Clinics provide complete ologists. Psychiatric services had to be almost
diagnostic laboratory analysis, treatment and completely eliminated at the two largest insti-
follow-up for tropical diseases-a significant pub- tutions-the House of Detention for Men and the
lic health problem in a major port city such as Correctional Institution for Men. Remaining
New York. Since 1974, the Lower East Side staff have had to carry increased patient loads.
Clinic has been closed and the Bushwick Health Laboratory Services
Center Clinic has been cut back while the Wash- Between 1975 and 1976, Public Health Labora-
ington Heights and Morrisania Clinics have been tory Services witnessed a 26% reduction in staff
left relatively intact. and a 10% reduction in the number of specimens
School Health processed. Free vaccine distribution and the
The School Health Program is divided into provision of tuberculosis testing material to pri-
the Elementary & Junior High School Division vate physicians have been eliminated.
and the High School Division. It is a screening Environmental Health
and referral system employing public health nur- The Environmental Health Services budget was
ses and paraprofessionals who review school health cut by 5% for FY 76-77. This resulted in more
records and organize work in each school for than a 20% loss in field staff for General Opera-
physicians, nurse practitioners and nurses. The tions. Further losses are projected to include elim-
Elementary & Jr. High program includes screen- ination of the drug audit and milk dating pro-
ing, admissions, follow-up and referral as well as grams, and reductions in the number of inspec-
daily inspections, nurse record review and con- tions of pet shops and stables, theatres and caba-
ferences. The High School program is similar, rets, surveillance of summer feeding programs,
except that more effort is directed towards the in-service training and food, water, fluoride and
specialized needs of High School students, such foreign substances sampling.