ADVOCATE:

Who You Gonna Call?

1. We need to fund and support community health programs.
2. We need to educate and support families dealing with disabilities.
3. We need to study the cause and successful treatment of mental illness.

Upcoming Workshops

Unless otherwise noted,  

all workshops will be held at:

The Dale Law Firm, PC  

Conference Room

127 Aspen Dr., Pacheco, CA 

Register by contacting shelley@dalelawfirm.com  

or by calling (925) 826-5585

SPECIAL NEEDS TRUSTS WORKSHOP FOR  

FAMILY MEMBERS  

 Two dates to choose from:

 10:00 a.m. - 12:30 pm

or   

Wednesday, March 13
6:00 p.m. - 8:30 p.m.

For more information on these and other workshops,  

learn more at

www.specialneeds alliance.org   

Dear Reader:

Welcome to a special edition of our Achieving Independence on-line newsletter. 

The recent tragedies in our schools and public venues where innocent people have been lost has shined a giant spotlight on the senseless violence rampant throughout our communities. My heart breaks for the families who have lost loved ones. I am also acutely aware of the desperate situations of the families of the attackers. Believe me, as much as society wants to blame them for their inability to control their loved one's actions, they're anguish began long before the act itself. Many of these families have had little to no guidance or support for years.  

The Judge David L. Bazelon Center for Mental Health Law released the following statement that I think best reflects my feelings: "The real problem is that community based services-including mobile crisis services, assertive community treatment, peer supports and supportive housing-are in short supply, delaying hospital discharges and resulting in mental health crises that could otherwise be prevented. While community mental health programs can offer excellent, comprehensive services, lack of resources has resulted in these services often not being available, except to people who are in immediate crisis and who have already endured multiple hospitalizations."

They further stress that... "A stronger commitment to vital community mental health services is long overdue and must be paired with improved gun laws in order to prevent future tragedies. This is a problem of political will; not know-how.

Furthermore, people with mental illnesses are no more violent than people without mental illnesses. Yet, these kind of tragic events unfairly and harmfully tar people with mental illnesses as inherently dangerous. In fact, these Americans not only share the nation's horror at these events, but also bear the additional weight of false stereotypes and discrimination needlessly reinforced by these perceptions."

So, what can we do?  I hope that this edition can provide some answers and some direction.  It's time for us to work together for change. 

The Achieving Independence Newsletter   

Are Good Intentions Enough? 

by Stephen W. Dale, LL.M., Esq. -  

The Dale Law Firm, PC

In 1963, President Kennedy called for Congress to replace institutions with comprehensive community programs that would provide outpatient care, day treatment, rehabilitation, foster care services, and public education with mental health and related services. Congress responded to President Kennedy's challenge by creating a commission that in turn recommended that communities take greater responsibility for the treatment of persons in institutions with locally-based programs. Because of the refocusing of services, the population in state mental hospitals from 1956 to 1980 fell by three quarters.

The Joint Commission also recommended a ten-fold increase in spending on community mental health programs and services over the next ten years, as well as an increase in training to ensure availability of the necessary workforce to serve this population. The idea was that funding would be redirected away from long-term institutional services to community-based hospitals and nonprofit agencies. Eventually, it was hoped that state hospitals would be completely replaced by a comprehensive community-based service system.

The federal government agreed to pay for the treatment of the mentally ill in community based programs and provided states with massive financial incentives to deinstitutionalize mental health treatment and to rely on the federal government to pay for the care of the mentally ill.

In one sense, the first stage of deinstitutionalization has been a complete success: very few people live in state institutions. Yet today's mental health system is a picture of broken promises and partially fulfilled dreams, and the developmental disabilities system is being eroded year-by-year. State and local policymakers discuss grand plans that, if implemented, might radically alter the experiences of people with developmental and psychiatric disabilities. But instead we see too little funding, an overburdened workforce, overwhelmed families, very poor, often marginalized consumers, and a system under siege.

The developmental disabilities service system is facing an unprecedented demand for services. Over the course of the past ten years, Autism has become a recognized epidemic. Meanwhile, the number of persons graduating out of the public school system and entering the world of adult developmental services is staggering, and the system is utterly unprepared. The U.S. has failed to invest properly in residential programs or adult day programs, and the big question is how are we going to serve these people?

One solution is advocacy. Social service providers need our support more than ever. Many citizens are unaware of the importance of the community social service system, and this lack of public awareness translates to weakened political power.

Another solution is knowledge. As stated by Chaz Gross in the paper The Heart Of The Challenge - Providing Public Education Regarding Mental Illness, "Combating the stigma surrounding mental illness and enlisting broad-based support for improvements to mental health policy requires education. Until the general public comes to understand mental illness as a physical illness, public support for improved mental health services is unlikely to increase."

Families are doing the best they can to access resources in order to provide acceptable care for their disabled loved ones. The problem is that the public doesn't really understand the importance of these programs, or the fact that most people with disabilities are living at a subsistence level. The general population must be made aware of the fact that the community service system is on the verge of collapse. They need to understand the true ramifications of such a collapse on persons with disabilities and their families, and they need to understand how this situation affects them. In short, we need to build passion and knowledge within the community. Only then can our elected representatives develop the political will to make the necessary course correction and commit the resources to revive the system.

An In-Depth Look at the Economic Factor

Let's get down to brass tacks.  Many residential programs are having difficulty keeping the doors open because of funding cuts.

California has instituted a rate freeze for residential service providers for the developmentally disabiled which has effectively lasted for a decade. This rate freeze has caused a stagnation of wages for direct service staff in group homes and supported living programs for over ten years.

Even when the economy is good and the state is not wracked by budget deficits, services for the developmentally disabled are woefully under-funded.

To further exacerbate this situation, many residential providers were forced to borrow against the equity in their agency-owned homes during California's recent budget stalemates because government inaction halted payments altogether. Providers had to continue to pay their staff, utilities, and insurance and feed their residents, despite the lack of payment from the state, and many had to go into personal debt to keep their programs operating. It is these same residential providers who are now faced with a rate reduction under the current year's budget. What is the incentive for individuals to enter this field of work? Why would a residential care provider who can barely manage to keep their existing homes open and operating seek to expand services and open new homes?

At the same time many community mental health programs have not been properly funded which have led to widespread homelessness for many persons with mental illness who would've traditionally been in state institutions.

Many experts believe that deinstitutionalization has contributed to "criminalization" of persons with mental illness. The fragmentation of service systems, easy availability and use of substances, and the unavailability of hospital beds for other than short-term acute care make it inevitable that many persons with serious mental illness in the community will, at some time, face arrest.

A Justice Department study estimated that in 1998, there were more than 280,000 persons with mental illness in jails and prisons, and more than a half million more on probation.

We can expect that states will continue to cut or freeze services for programs for the disabled community for at least the next decade and that competition for those services will become more intense.

In California residential services for persons with developmental disabilities have been frozen and there is no spending on new programs to meet the expected increased need. HUD programs have long waiting lists and the increase in the non-disabled community seeking housing assistance because of unemployment and poverty is putting further strain on residential programs based on government assistance.

We can expect that many services that have been developed over the past 30 years such as respite care and day programs will close due to lack of funding.

This is problematic for a number of reasons. First, these programs are essential not only because they enhance the quality of life of the consumers utilizing the programs, but they also give families and caregivers a much needed break.

The second problem is that it takes years to create these programs, train staff, and integrate their services in the community. Even if the effects of the recession to end tomorrow, programs cannot be put in mothballs. It isn't practical to resurrect these programs overnight when the funding returns. When the programs shut their doors, the real estate is sold and the workers find other professions. In another words, when the program is gone - it is not likely to return for many years.

At the same time, public agencies and caseworkers who traditionally monitor the welfare of persons with disabilities are having their budgets cut and caseloads increased. Agencies and caseworkers that oversee services for disabled consumers cannot provide adequate oversight to ensure the quality of services are appropriate and that that each consumer is safe. We can anticipate that the lack of oversight by the traditional government entities will increase the possibility that Tiny Tim will be subject to abuse, or will live in substandard conditions.

The shortfall from our budget crisis under the best of circumstances is going to cause instability to programs that depend on state or federal aid. As advocates, we need to do everything we can to preserve our social service system.