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Dear Bryan:
You’re doing good work as “chair” of the House
Interim Committee on Habilitation Centers. As a former legislator, I
appreciate your time and commitment. Here are my thoughts after
attending the three sessions in St. Louis, Marshall and Joplin:
GENERAL
Mo. has a good balance of public/private residential
service delivery. Competition keeps everyone “on their toes.”
Habilitation Centers play a vital role in that
balance and, in addition, provide the safety net for extremely
difficult clients
The Superintendents and their staffs are very
impressive; our most vulnerable citizens are in good hands
The facilities are generally in good shape and
provide the appropriate care and security these people need and
deserve
MISCONCEPTIONS
While the Olmstead court decision does encourage
community placements, it also recognizes the appropriateness of
Habilitation Center placements!
Contrary to some testimony, most residents of
Habilitation Centers CANNOT make life decisions for themselves.
Parents/Guardians are charged with those responsibilities
I find it disingenuous when “not-for-profit”
providers suggest they aren’t interested in money. There’s no
money to remove people from waiting lists, therefore, their only
prospects for new business reside in Hab. Centers!
Costs were thrown around and most were inaccurate.
Hab. Center Medicaid earnings [over $92M] return to general revenue
and don’t show up in Mental Health’s budget.
Automatic assumptions that community services are
better than Hab. Centers: While most community providers do good work,
they operate under less comprehensive regulations and sometimes give
less quality care. Auditor McCaskill’s recent audit confirmed that
more abuse & neglect occurs in the community and further, much of
it never gets reported because of lack of oversight!
RECOMMENDATIONS
Hire more retired direct care staff as part time
employees and encourage more “flex” time with current staff to
minimize mandatory overtime
Cancel the “for-profit” drug & food
contracts that have been found to cost more as soon as applicable.
Re-evaluate outsourcing/privatizing to ensure
anticipated savings are achieved
Don’t make major changes in our system; it’s
working well.
If state income continues to stagnate, consider new
revenue. While personal/private acts are good, they cannot substitute
for the public responsibility of government to provide a safety net
for our most vulnerable citizens.
CONCLUSIONS
Looking for efficiencies in state agencies and
services is an appropriate exercise by elected officials. We need more
of it in government, especially in these tough economic times. You are
doing good work.
These visits show that appropriate mental health
services are complex. There is no one right answer for everyone. Our
current system is working. The fact you and members of our Legislature
have direct oversight and access to many of these programs [State
operated] is comforting. Good luck on your quest.
Your friend,
Jerry Ford,
Executive Director
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Never mind parents don’t
approve AND were never consulted;
