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History of the Blind in California
As a necessary part of the well-rounded function of the two public assistance programs for the blind, California developed a prevention-of-blindness or a sight restoration program witch, during twenty-one-years, was the means of restoring sight to more than 5,000 blind persons.
In 1934 the legislature granted the State Department of Social Welfare the authority to provide treatment or surgery to prevent blindness or to restore the vision to a person applying for or receiving Aid to the Blind. However, an appropriation to fund the program was not made until 1945, when the sum of $50,000 was made available for the biennium of 1945-1947. During the first year of the program twenty-four persons had surgery of which twenty-two gained greatly increased vision. For the fiscal year ending June 30, 1963, a total of 604 surgeries were performed including 550 cataract extractions.
About 92.1% of all cataract surgeries resulted in improved vision. In 1962 the source of payment for most surgeries was shifted from the special Prevention of Blindness appropriation to the state’s Medical Care Fund and the service was greatly expanded by extending it directly to recipients of Old Age Security and Aid to the Totally Disabled, resulting in an increase of 84% in 1962-63 over the number of surgeries performed in 1961-62.
The social implications of the Prevention of Blindness Program can only be fully revealed by a detailed study of the results in the individual cases contained in the progress reports which provide inspiring reading. While most of the recipients of care under the program are beyond the age of productive work, the restoration of sight is very important to these persons in terms of effecting physical and social adjustments. These results are felt not only by the person but by the family, relatives, neighbors and the entire community. In addition, it is estimated that cataract surgeries performed in the 1962-63 fiscal year resulted in a savings in expenditure of public funds of approximately $83,000 a year. This is due to the decreased numbers of persons receiving public assistance of any kind following surgery (including eighteen who became gainfully employed), and the lower average grants received when Aid to the Blind recipients transfer to other public assistance programs upon restoration of their sight.
While the program was state administered, too much credit cannot be given to the staffs of the county welfare departments which cooperated fully and enthusiastically. It was the great amount of work done by counties which made the program so highly successful.
Although eye care was still available, it is most unfortunate that this successful program should have been brought to an end with the beginnings of the California Medical Assistance Program (Medi-Cal) on March 1, 1966. Under the new program there was, apparently, no room for prior authorization and hence no quality control.