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i <br /> 24 <br /> Of the number employed in 1969, nine are employed in a <br /> generalized nursing service, 15 in home visiting only, 21 in <br /> schools, 3 in headstart and 7 as consultant-directors, exec- <br /> utive director and/or supervisor. Of the total of 55; 15 are <br /> prepared public health nurses. Eight were newly employed <br /> and needed orientation. <br /> Services provided had more emphasis on direct super- <br /> vision of nurses employed by towns and schools; all town <br /> nurses are now using one of the standard methods of keep- <br /> ing patient-care records, keeping a daily and monthly statis- <br /> tical record of kinds of cases and kind of care given, age <br /> distribution and type of payment made. Analysis and evalu- <br /> ation ,of data will be done. <br /> Some proposed plans for the coming year are: <br /> 1. Strengthening the maternal and child health serv- <br /> ices by in-service education programs and individ- <br /> ual direction. <br /> 2. Developing more meaningful service by the public <br /> health nurse as a part of the State Crippled Chil- <br /> dren's program. <br /> 3. Participating in the development of policies for <br /> school health programs through committee involve- <br /> ment. <br /> 4. Strengthening the role of the professional advisory <br /> committees: for example, policy and programs de- <br /> veloped for Home Health Agencies, Cape Cod Com- <br /> munity College Health Service and Headstart health <br /> services. <br /> 5. Study and evaluation of supervision provided to <br /> nurses; review of all nursing activities related to <br /> the purpose of improvement of nursing service in <br /> Barnstable County. <br /> Social Service <br /> The medical social worker has completed the first full <br /> year in this new position to the County. She serves as con- <br /> sultant to all members of the health department staff,Board <br /> of Health, community and school nurses, local physicians, <br /> hospital and nursing home professional personnel, and all <br /> public and private agencies. <br /> An important phase of the program has been to establish <br /> a workable referral program, providing proper use of re- <br />