An almshouse was first erected in the Town of Boston in 1662. The first building burnt down. In 1682, the town voted to rebuild it and specified the object of the institution: it was “for the relief of the poor, the aged, and those incapacitated for labor; of many persons who would work, but have not the wherewithal to employ themselves; of many more persons and families, who spend their time in jolliness and tipling [sic], and who suffer their children shamefully to spend their time in the streets, to assist, employ, and correct whom the proposed institution was provided.” The Boston Almshouse was established in 1725 on Beacon Street. The building on Beacon Street was discontinued in 1801 and a new almshouse was built on Leverett Street. The need to separate the “worthy poor” from the “vicious poor” led to the establishment of a House of Industry and a House of Correction in the 1820s. The almshouse on Leverett Street was sold in March of 1825. The poor were transferred to the House of Industry in South Boston.
The Almshouse Department within the House of Industry held responsibility for all the paupers who were admitted to the House of Industry. In 1853, the House of Industry was removed to Deer Island. Due to population constraints at the Deer Island facility, all of the male paupers in the Almshouse were transferred to the newly opened Home for the Poor on Rainsford Island in October 1872. All the female paupers were transferred to the Home for the Poor at Austin Farm in April 1876. Finally, in 1877, the boy paupers were moved to the Marcella-street Home and the girl paupers followed in 1881.
In 1887, the female paupers were transferred from Austin Farm to the Almshouse at Long Island. One year later, in 1888, the male paupers and female paupers traded places. The men moved to the facilities on Long Island and the women relocated to the buildings on Rainsford Island. In 1894, the male and female paupers were consolidated on Long Island in the newly established Boston Almshouse and Hospital, being the principal Almshouse for Boston. However, the Almshouse on Deer Island was still in use at this time. Most inmates were admitted to the Almshouse on Deer Island because they were suffering from delirium tremens. Once the State took over the care of the insane in Massachusetts, delirium tremens cases were no longer sent to almshouses after May 1, 1910. After this point, inmates in the Deer Island almshouse were mainly inmates just released from the House of Correction. In December 1924, the name of the Boston Almshouse and Hospital was changed to Long Island Hospital since many attached a negative connotation to the word “almshouse.”
Responsibility for care of all paupers fell to the Directors of the House of Industry from 1822 through 1857. In 1857, control for all public institutions was given to a Board of Directors. Thus the Almshouse and all the Homes for the Poor (Rainsford Island, Long Island, and Austin Farm) moved under the auspices of the Board of Directors of Public Institutions. In 1889, a Board of Commissioners replaced the Board of Directors and jurisdiction for the Homes for the Poor and the Boston Almshouse and Hospital transferred to them. In 1895, a single Institutions Commissioner took over for the Board of Commissioners. In 1897, individual departments were established for the various institutions. The Pauper Institutions Department (becomes the Infirmary Department in 1908) received control over the Boston Almshouse and Hospital on Long Island and the Boston Almshouse for Women and Aged Couples in Charlestown.
In 1920, all the individual departments were consolidated into the Institutions Department. The Infirmary Department became a division within the Boston Almshouse and Hospital. On June 1, 1954, the Long Island Hospital was transferred out of the Institutions Department and became the Long Island Division of the Hospital Department. At this time all responsibilities for those once classified as “paupers” passed to the Welfare Department.