For the second time in two years, outpatient services at the Hillcrest Children's Center, a mental health clinic for youth, are being reviewed with an eye toward major program changes.

"Initially they were going to relieve all of the (outpatient) staff (members) July 1 and attempt to run out (patient) services with in-house clinical staff," from the school and residential programs, said Dr. Guy Ruth, executive director of the center. Six people would have lost their jobs.

Instead, the center's board of directors will meet Tuesday to vote on a proposal to keep one outpatient staff member as a coordinator of outpatient services and to hire the others on an as-needed basis said Ruth.

Although Ruth opposes the proposed reorganization of the clinic, he said he submitted the alternative proposal to the board because outpatient services were being threatened by financial problems and interanl politics.

Norman Taylor, a spokesman for the United Way, which helps fund the center, said his agency was not informed of any proposed service changes at the clinic. He said the United Way has been pleased with services rendered by Hillcrest in the past and has even increased their grant for 1979.

"They're going to lose that money unless they keep that (outpatient) project," Taylor added.

Ruth said the grant was increased from $19,000 to $24,1000.

"What we're doing is reorganizing," said Dr. Joan Barber, the newly appointed medical director at Hillcrest who is overseeing the changes. "Our center wants to go for accreditation and we want to make sure children are getting complete evaluations,"

Barber said the center needs more medical and educational specialists to seek accreditation and to fully evaluate youths with learning problems. The center is seeking an educational specialist and a speech pathologist to help upgrade its clinical services, she said.

Next year District schools will begin to evaluate children at the age of 4, continued Barber. She said Hillcrest intends to be prepared to evaluate any children in this age group who might be referred to the center.

Hillcresr staff members, who asked not to be identified, said they fear that an emphasis on specialized mental health services for a younger age group will eventually lessen services for the population they are now serving.

The center primarily serves lower-income, black children in the 6-to-12 age range from the Cardozo area. However, families in higher-income brackets are also referred to the center.

In the late 1960s and early 1970s, Ruth said, the center redeveloped its services. It had a large training program for psychiatrists, psychologists and social workers. Whether youths were treated often depended on their being articulate and motivated to receive it. Eventually the center began to lose appointments and to develop economic problems, said Ruth.

In December 1974, the outpatient clinic was closed. It reopened again in January 1977 with services in limited psychological testing, family counseling and psychological treatment. In addition, staff members began to serve as consultants for local social service agencies, such as the D. C. Association for Retarded Citizens. A smaller outpatient clinic, open Tuesday evenings, provided short-term treatment for youths who were truants and behavior problems. Youths treated in both clinics ranged in age from 6 to 18.

Between the 1977 reopening and April 1978, Ruth said, the two outpatient clinics have seen about 172 clients, most of them in the larger clinic. The outpatient clinic now has 46 patients in therapy and 20 on its waiting list. Fifty-one children are in the residential and day school programs, which are administered by a 34-member staff, said Ruth.

In recent years, Ruth said that Washington, along with several states, has been struggling to cope with problems of juveniles when they first begin getting into trouble.

"Quite frankly this population frightens many mental health professionals," he said. "Therefore these kids don't get too much help."

"Taking care of 46 cases in active therapy in not that big a deal," said Barber. "Neither is a waiting list of 20."

If the center is to weather the monetary problems and expand, she said, it must provide a wider range of services to a larger population.

The Hillcrest Children's Center was founded in 1815 by Dolley Madison. Since that time, it has served the Washington area as an orphans' home and in 1954 became a mental health center for children.