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Archived
News and Projects State Needs to Upgrade Care for Disabled
State needs to upgrade care for disabled WHEN the bottom line becomes the driving force in social service reforms, patients or clients lose. It cuts across both good programs and those past their prime.
While one-size-fits-all may please the pocketbook, it often lacks necessary flexibility -- and consequently humanity.
The California Legislature and Department of Developmental Services may be on the verge of committing such a sin.
Assemblywoman Dion Aroner, D-Berkeley, has introduced a bill (AB896) that would close five remaining residential development centers in the state and send inhabitants to nonresidential regional and community centers.
Economically, it appears logical. The campus-like centers have $600 million annual budgets and 3,800 residents, which translates into an annual average of $167,683 per patient. Community centers serve 170,000 disabled at a cost of $11,525 per person, most of whom live with their parents.
Closing residential centers and combining budgets with that of community programs seems to make sense. But purely economic Cadillac/bicycle comparisons mask a lot of problems.
Funding, programs and care at community centers are often inferior and inadequate. A 1999 report by the Bureau of State Audits found that budget cuts and insufficient funding undermine community centers. And whose responsibility is that? State and federal government's.
STAFF WRITER Michelle Marcucci of ANG Newspapers found staff at community centers is often untrained, underpaid and unqualified to care for people who are mentally retarded, autistic or live with cerebral palsy and other disabilities. Drugs are used to control behavior. For medical help they rely on 911.
Residential centers offer an array of services, trained staff and regular access to medical care. The quality of care is reflected in the fact that for many residents it operates as a safety net when prior services fail. It succeeds where other programs don't.
There also is a philosophical debate over whether such patients are better off being part of the community. That depends on the conditions of individuals, which vary widely.
The state's haste to close residential institutions and channel the developmentally disabled into community centers smacks of the blunder made when we shuttered mental health institutions. Community programs were supposed to fill the void, but haven't. Chronic homelessness instead became a way of life.
Clearly, the transition to community-based treatment has not been exemplary. In 1993, 2,300 residents were released into communities with a state allotment of $334 million to build group homes and develop day programs. A year later, the Legislature cut $106 million from that total. It's never been replaced.
Closure of centers in Stockton and Camarillo gave free land to the state university system, but did nothing for the disabled. And $111 million received for campuses in Santa Clara and San Jose went into the general fund, not programs for the disabled. Dozens of residents died when moved from the closed institutions. A 1997 study of 20 deaths concluded that 11 were questionable and 5 preventable.
Do we trust the state to do the right thing for the developmentally disabled now? Its track record says we shouldn't. The idea is to combine the budgets, sell the property and use the money to help the disabled. Unfortunately, state officials reneged on similar pledges in the past. A shameful performance.
We don't believe all residential institutions should be closed. Deinstitutionalization isn't the answer. Some need the safety net residential institutions offer.
And, all at the community level deserve better care and options. Our treatment of the disabled suffers the same ailments as elder care -- inadequate funding, improper medical care, poor pay and too few trained attendants.
When, if ever, will the state of California fully accept its responsibility and provide a comprehensive program that offers adequate care and options for its developmentally disabled citizens?
A society's compassion and goodness is best measured by how it cares for its neediest members. We seem to be backing off our commitment to the developmentally disabled, moving them into an inadequate, one-size-fits-all world. That should be beneath us.
Californians have the wherewithal, and hopefully the decency and humanity, to provide the necessary range of options for these fellow citizens. We should offer treatment, programs and lifestyle alternatives that recognize and respond to the differences among them.
As parents of many disabled citizens attest, we should retain -- and upgrade -- some residential developmental centers for those who need them and as a safety net for those who later require close supervision and care. Group homes and other intermediary facilities offer a middle ground.
Closing all residential institutions for the developmentally disabled is shortsighted and should be opposed.
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