OBS FOR THE HOMEBOUND is a 5year demonstration project in vocational rehabilitation operated by the home care department of Montefiore Hospital in New York City. The project is a direct outgrowth of the department's 11 years of experience in providing comprehensive medical care at home to chronically ill, medically indigent patients. The home care department provides treatment for 85 to 95 patients in the Bronx and upper Manhattan. The patients' illnesses are of such severity that they are unable to attend outpatient clinics and can be maintained at home only with close medical supervision. Care is provided by a medical-social team composed of physicians, social workers, nurses, recreation and art therapists, and physical therapists. Basic to the philosophy of the home care department is the belief that an indispensable component in medical treatment of the patient is helping him cope with the overwhelming emotional, social, and economic needs which arise with long-term illness. One of the most prevalent of these is the patient's need for meaningful activities appropriate to his physical condition. Without such activity the patient becomes apathetic and withdrawn, and he may suffer both medically and psychologically. From the inception of home care, services included a program of diversional activities, and this provided satisfactory occupation for the majority of patients. However, some patients seemed unable to derive satisfaction from leisure-time activities, and from them came a small but very steady stream of requests for real work. Unfortunately, the community had no facilities for the vocational rehabilitation of homebound patients who were as sick as those found in home care. A survey of rehabilitation facilities for homebound patients in other parts of the country showed that the type of patient seien in home care was consistently excluded from vocational rehabilitation services. It was decided that the home care patients' persistent requests for work could not be ignored and that investigation of the possibility of their engaging in economically productive activity was warranted. The jobs for the homebound project was initiated on March 1, 1956. The investigation was supported, in part, by a demonstration special project grant from the Office of Vocational Rehabilitation, Department of Health, Education, and Welfare. The New York Chapter of the Arthritis and Rheumatism Miss Clarke is co-director, with George M. Warner, M.D., home care executive, of the jobs for the homebound project, department of home care, Montefiore Hospital, New York City.