Re: Fw: PFA Speaks: Push For Access Monthly Newsletter for November 2011

[Guest guest]

Well written, even if I don’t agree with most of what’s being said. I

always get confused on this – are these the same peeps who once ran VOR

(can’t even type out the whole name)? Because I seem to recall reading

somewhere that the parent who runs their new group has like a $100,000 budget to

do her thing. Is this parents, self-advocates, unions...who is speaking on

behalf of these individuals living in our SODCs?

Thanks for sharing this.

From: ELLEN BRONFELD

Sent: Thursday, November 10, 2011 4:26 PM

IPADDUnite ; Helen Kauffman ; Ellen McManus ;

Cochran ; Eileen Bennin

Subject: Fw: PFA Speaks: Push For Access Monthly Newsletter for

November 2011

PFA Speaks: Push For Access Monthly Newsletter for November 2011I think this

helps to provide a frame of reference and perspective on the subject of state

facility closures.

Ellen

Ellen Garber Bronfeld

mailto:egskb%40sbcglobal.net

PFA Speaks: Push For Access Monthly Newsletter for November 2011

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PFA Speaks

The Push For Access Monthly Newsletter

May 2011

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Do We Have a Plan?

Illinois’ system of care for individuals with disabilities is in serious

jeopardy. In response to what he has deemed an inadequate budget Governor Pat

Quinn initiated a series of budget management strategies, which included a

proposal to close seven state-operated facilities – including two correctional

facilities, three mental health hospitals and two developmental centers.

Quinn’s proposal was met with strong opposition from community activists over

ill-conceived time lines and poor resource allocations. This opposition should

come as no surprise to the Governor, as his actions were quite different than

his self-proclaimed intentions. Speaking of community care and

de-institutionalization Quinn stated, “… that (transition to community care,

or de-institutionalization) doesn’t happen overnight, and we don’t do this

where we just push vulnerable human beings out on to the street without proper

planning and coordination, it may take more than one fiscal year, uh, but

we’re going to do this in Illinois and I look forward to doing it.†Perhaps

the Governor has come to realize his proposal will not lead to individuals with

disabilities living a “fulfilled life to the best of their abilities…â€

Yesterday, Quinn’s office released a long-term rebalancing initiative which

seems more focused on the long-term aspect of successful

de-institutionalization.

The release of the long-term re-balancing initiative came just before the

Commission on Government Forecasting and Accountability (COGFA) will cast its

final votes for the last three remaining facilities slated for closure. The

Commission has already voted to reject closing four of the state-operated

facilities – Chester and Singer Mental Health Centers, Jack Mabley

Developmental Center and Illinois Youth Center at sboro. Earlier this week

formal recommendations were filed by the Commission which provided reasoning

behind its decisions to reject the closures. In their explanation COGFA members

noted concern with the lack of safety in the transition plans. Those concerns

were centered around funding and its affect on the community’s capacity to

provide the necessary supports, the main point raised by many community

activists.

The re-balancing initiative does vary considerably from the Governor’s

original proposal. For starters, it will look to close four developmental

centers, as opposed to two. The selection of those two additional facilities

will be determined during the General Assembly’s next Spring session. Tinley

Park and only one other mental health facility to be determined are planned to

close throughout fiscal years 2013 and 2014. According to the initiative, the

Governor’s office looks to capitalize on the Affordable Care Act reducing the

need for state psychiatric beds as more and more individuals who currently seek

care from state hospitals will be covered under private insurance and Medicaid,

which will make them more appealing to a private hospital. Also, the two

correctional facilities have been taken off the books. The time lines for the

closures have been extended, which will give lawmakers an ample amount of time

to allocate necessary funding.

The main problem with the Governor’s original proposal was a fundamental one

in that a major policy decision such as the closure of state-operated facilities

for individuals with severe disabilities should not be strictly budget driven.

It is a process that requires strategic planning, appropriate community

investment, adequate rate adjustments, and a high level of public involvement to

ensure a strong network of community support is available. A host of community

providers are capable and willing to serve those transitioning individuals, but

they need the state to commit to properly fund the needs of those making the

transition, whether that is specialized medical or behavioral supports or living

arrangements.

The Department of Human Services’ Division of Mental Health proposed

restructuring its system of care as a long-term policy goal, as opposed to the

closure of three state-operated mental health facilities, which is purely budget

driven. The state is statutorily mandated to provide forensic mental health care

– care for the criminal mentally ill – so that is where its focus will

remain, while much of the acute and long-term care services will be transitioned

to community providers. However, the time frame initially proposed to drive this

process would result in a dramatic loss of psychiatric beds available to the 18%

of Illinoisans that suffer from mental illness, as there currently is no plan in

place to address this particular issue. Three less state-operated mental health

facilities will mean that many fewer beds are available to assist individuals

with serious mental illness if/when they have a crisis, which is a detrimental

effect on their ability to receive care for an acute episode. A more reasonable

alternative would be to establish a long-term strategic plan to safely

transition those individuals by utilizing governmental cooperation and

facilitating community involvement. For example, recently passed legislation

requires the Division of Mental Health to create a Mental Health Services

Strategic Planning Task Force that is charged with creating a comprehensive

5-year strategic plan for Illinois’ mental health system of care by 2013. If

its early discussions are focused on the role of state-operated mental health

facilities in the system of care, then recommendations can be implemented to

properly address necessary system restructuring, community provider capacity,

reimbursement rate adjustments, etc.

The Director of the Division of Developmental Disabilities admitted his concern

with the transition of individuals from state-operated developmental centers to

community-based providers is that the rate paid per individual at a center for

independent living is inadequate already, and nearly half of what was paid in

his previous home state of Pennsylvania. Combine that fact with the influx of

individuals transitioning from the State-Ops, and it is hard to envision a safe

and smooth process. Community-based providers have no doubt in their ability to

care for those individuals given appropriate resources.Their apprehension lies

in the State’s ability to hold up its end of the bargain. Historically, the

state has been less than reliable when it comes to properly allocating

resources, let alone in a timely manner, which only compounds their anxiety. The

state must first assure funding for those providers will be available, and that

the closure time frames will be driven by the needs of the individuals.

It is important to note that COGFA’s recommendations are not binding.

Spokespersons for the Governor have stated his recently released long-term

re-balancing initiative has been their preferred course of action from the

beginning. However, if budget re-allocations are not made to allow the

facilities to remain open for the rest of this fiscal year, then they say there

will be no choice but to go through with the original proposal. In the past,

COGFA recommendations have always been followed, so deviation from past practice

could prove detrimental to a Governor that relies on public support.

Community stakeholders must be vigilant in holding State government accountable

and to be sure any facility closure is done for the right reasons in a

reasonable timeframe. Only time will tell if our government leaders will follow

through with a strategic approach, or if we will have once again missed out on

an opportunity to make Illinois a leader in providing high quality community

supports and services to individuals with severe disabilities in the most

integrated and appropriate setting.

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