Has Deinstitutionalization Failed?“
“Has Deinstitutionalization Failed?”
Deinstitutionalization
In
the 1980’s, Senator John Chafee (R., RI) introduced legislation that would have
defunded Medicaid Intermediate Care Facilities (ICFs). Since then, the push to
de-institutionalize has gained momentum. As of 2011, twelve states had no large ICFs; AL, AK, DC,
HI, MI, MN, NH, NM, OR, RI, VT, WV; and three states had no ICF of any
size; AK,
MI, and OR.
Today,
despite the objections of guardians and advocates, many states are closing or
redefining their ICFs; forcing individuals from their homes and into community
services or leaving them without services. Nationally, there are 317,000
individuals on waiting lists for Medicaid Waiver services. There seems to be a direct correlation
between deinstitutionalization and waiting list numbers. Alabama requires capacity to grow by 69.3% to
meet needs. Alaska requires 50.3%, New
Mexico requires 144.4%, and West Virginia requires 114.4% growth in capacity. 853,000
persons are living with caregivers age 60 or older.
Community
Tragedies
An audit by Tennessee’s state comptroller and
federal court monitor’s report tracking individuals transitioned from three of
the state’s facilities found:
257 reports of abuse, neglect, and exploitation in 2013 (87 of those
reports were validated by the state); delays in doctor recommended treatments
and lack of adequate dental care; and an increase in deaths of persons formerly
institutionalized (nearly doubled from 2009 to 2013). Some former residents of institutions have
landed in jail while others cannot be found. 
”While the state saves millions of dollars each year by serving people
outside institutions, officials at private agencies concede that a lack of
adequate state funding has at times hampered their efforts to help people
achieve the best quality of life,
”
Anita Wadhwani, reporter.
In New Jersey, state facilities
are being closed while individuals receiving care out of state are being forced
to return to New Jersey or lose their funding.
The individuals being served out of state were allowed to receive
services in other states because New Jersey had no facilities which could provide
the services they required. After the
deaths of two state facility residents transferred to group homes, the New
Jersey Legislature passed a bill creating a moratorium on the Return Home New
Jersey Initiative but Governor Christie vetoed the measure. Family groups have claimed that the state is
bringing people back without having the services and group homes in place for
their arrival. One young man has been jailed and hospitalized because the group
homes he moved to were not able to handle his behaviors; he was thriving in the
out of state facility where he lived and even worked part-time. ”While the state saves millions of dollars each year by serving people
outside institutions, officials at private agencies concede that a lack of
adequate state funding has at times hampered their efforts to help people
achieve the best quality of life,”
Anita Wadhwani, reporter.
Oklahoma has had seventeen deaths
over a period of twenty-two months.
These individuals were either transferred or in the process of being
transferred from two of the states ICFs.
State Senator Patrick Anderson has called for a review of these deaths
to determine “whether the impending closure of the
facilities and the residents' transition into community homes contributed to
the deaths.”
“Has deinstitutionalization
failed?”
At a recent Facilities Task Force
Meeting, Senator James Anderson, Senate District 28, posed the question, “Has
deinstitutionalization failed?”
Yes, Senator Anderson, deinstitutionalization has failed. The preceding examples are only part of the answer
to that question. There are numerous
stories from across the nation illustrating the negative outcomes of
deinstitutionalization. These are just a
few. It has failed the displaced
residents of the institutions they called home.
Individuals have the right to choose where to live and receive services;
however, deinstitutionalization has eliminated that choice. Deinstitutionalization has denied individuals
the integrated, client-centered care they have received in these
facilities. Overall, it has attempted to
put persons with intellectual and developmental disabilities into one category. This “one size fits all” approach to caring for
the intellectually and developmentally disabled affects each individual
regardless of the severity of their disability.
References
Larson, S.A., Salmi, P., Smith, D., Anderson, L. and Hewitt, A.S.
(2013). Residential
Services for Persons with Intellectual or Developmental Disabilities: Status
and trends through 2011.
Minneapolis: University of Minnesota, Research and Training Center on Community
Living, Institute on Community Integration.
posted by Unknown @ 11:11 PM
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