The 977 retarded
men and women still living in six state-run institutions are known
in Department of Mental Retardation circles as "stayers."
The "movers" are the roughly 8,500 DMR clients living
in privately-operated group homes that often accommodate four to
six residents. Another roughly 1,000 men and women with intellectual
disabilities live in DMR group homes operated by state workers.
All too often, policy disagreements between these groups are resolved
not through consensus, but litigation.
The Fernald
Development Center in Waltham is the current legal battleground
between the "stayers" and the "movers." Many
of the 186 people living there also have serious medical complications
requiring ventilators, feeding tubes, and other devices. Their relatives
and guardians praise the quality and continuity of care at Fernald,
where many elderly residents have lived for decades. DMR, however,
wants to move people out of the facility. The Patrick administration
is even challenging the standing of federal Judge Joseph Tauro,
the longtime monitor of the institution who humanely proposes that
residents be allowed to remain.
Patrick's priorities
emerge
The Patrick administration has stopped short of former governor
Romney's call for the outright closure of these six state campuses.
But the administration's views are starting to emerge, and they
don't favor the future of the six institutions. "Why perpetuate
that model," asks Dr. JudyAnn Bigby, the state's secretary
of human services, "when people can be successfully moved and
placed in smaller, community settings?"
Those will sound
like fighting words to the Coalition of Families and Advocates for
the Retarded, whose members argue persuasively that care is often
more consistent at the state institutions, where higher salaries
and better benefits result in less frequent staff turnover. For
COFAR, the presence of on-site physicians and 24-hour nursing care
at Fernald and other state facilities easily trumps the group home
with a picket fence.
But Bigby's
message is sure to be music to the ears of Massachusetts Arc (formerly
the Association of Retarded Citizens) a powerful advocacy group
for retarded residents in the state. It enjoys the support of the
private vendors who operate roughly 2,000 group homes under contract
with DMR. The director of Arc, Leo Sarkissian , argues that equal
or better treatment is available in private group homes for even
the most medically fragile residents. Arc estimates that keeping
the six state institutions open would require $210 million in capital
expenditures alone over the next 20 years, money better spent on
community care.
Finding the
right balance between institutional and community-based care now
falls to DMR's new commissioner, Elin Howe. She refused last week
to comment on the future role of the institutions or any other DMR
business until she arrives here next month. Howe, the former commissioner
of the New York state office of retardation, will need superior
diplomatic skills. Outgoing commissioner Gerald Morrissey enjoyed
the respect of both COFAR and Arc, and not even he was able to craft
a compromise at Fernald agreeable to both sides.
Ample room for
compromise
One thing is certain: There is plenty of land on which to accommodate
the state's retarded residents. US Attorney Michael Sullivan, the
court-appointed monitor in the ongoing litigation over the right
of residents to remain at Fernald, surveyed the six institutions
during his year long analysis of the services offered by DMR. He
expressed surprise at the "vast acreage surrounding the state
institutions" in a March report: 123 acres at Glavin in Shrewsbury;
54 acres at Hogan in Danvers; 400 acres at Wrentham; 588 acres at
Monson in Palmer; 186 acres at Fernald; and 2,600 acres at Templeton
in Baldwinville.
One good approach
would be to solicit bids for the land from private housing developers,
provided they agree to build group homes for the retarded on the
periphery of the campuses or set aside units in their developments.
These could serve the roughly 200 new DMR clients who arrive each
year in need of residential services. Respite care could be offered
on the grounds for use by the thousands of families who now receive
only limited home-based services for their retarded relatives, or
none at all. Campuses in key locations could still provide the intensive
medical care needed for the most medically complicated cases.
Creative solutions
would first require Arc and its supporters to stop the provocative
campaign to close all of the institutions. In turn, COFAR and its
supporters would need to agree on a long-range consolidation plan
that leaves some campuses in place with a full array of intensive
medical services while planning for the closing of others. As long
as the two groups are squabbling, there is no real incentive for
DMR officials and state redevelopment experts to come to the table.
Most town officials
know better than to discriminate against people with disabilities.
But selectmen and other elected officials are likely to resist any
new housing developments on state properties. They argue that such
growth places too many demands on local services, especially schools.
Legislators do the bidding of local officials on such homegrown
issues. But a true coalition of advocates for the retarded could
counter that trend. The Patrick administration could also pitch
in by appointing members who favor compromise to the lapsed Governor's
Commission on Mental Retardation.
All disabilities
are not created equal. The state needs both group homes that offer
maximum independence and medically-intensive facilities that offer
round-the-clock nursing care. The physical space is there if the
Patrick administration and the advocates for the retarded can summon
the will.
