Administrative History

Dr. H. Jackson Davis was employed by the State of New York from circa 1930-1945, working first for the Department of Health (series A3273) and then for the Department of Social Welfare (series A3274). As Chief Medical Officer with the New York State Department of Social Welfare from 1938-1945, Davis was responsible for establishing the first statewide health care program for persons on relief, since by June 1937, the Department of Social Welfare had assumed the function of continuing necessary state aid for persons on relief, which was previously handled by the Temporary Emergency Relief Administration (TERA) under the general supervision of the Department of Health.

While the medical care program was to be state-aided, it was set up to be run by local welfare districts throughout New York State, with the goal of preserving free choice and local autonomy in the provision and delivery of services. The Department of Social Welfare established a set of minimum requirements for the districts to follow, including the principle of "medical and social coordination": the use of physicians to determine medical needs of any person applying for medical care; the use of social workers to determine the financial eligibility of persons applying for care; and the cooperation of medical and social professionals in providing patient-centered care. While minimum standards were in place, local plans could (and did) differ widely on how they provided health care services. Some adopted fee-for-service plans, while others relied on rotating panel systems of physicians, whereby a pool of salaried doctors agreed to participate for a specific period of time before being replaced by another group of physicians.

Not only did the Department of Social Welfare establish standards for the local health plans, it also mandated the process by which a plan was created, reviewed, and approved. First, the local welfare district would undertake a medical survey, which included an identification of all public and voluntary agencies within its borders. Second, it would establish its fees system and draft a "local manual of medical care," which would be reviewed by advisory committees. Third, it would submit the draft plan to the State Department of Social Welfare for review and approval. Fourth, after receiving approval, the local public welfare commissioner would publish the plan and distribute it, ensuring that copies were filed with the Department of Social Welfare and State Department of Audit and Control, for use in granting appropriate state aid monies. Fifth, it would assign staff members, including the Medical Director, to a central medical unit within the specific local welfare department. The unit staff would typically include a physician, medical social worker, medical worker (either nurse or social worker), pharmacist, clerical workers, and accounting specialists.

Due in large part to the program's success - by May 1943, New York State had thirty state approved local medical care plans in place in areas covering more than 80 percent of the recipients of public assistance in the state - H. Jackson Davis was consulted by Harry Hopkins and other members of the Roosevelt Administration in establishing a federal program based on the New York state model.

During the 1940s, after his service in the Department of Social Welfare, Davis served as the director of the first county health department in New York State, in Cortland County.