Sacramento Bee (August 22, 2001)

Unequal treatment: Money for Disabled Belongs in Communities.

Changes in the law and in treatment philosophy have led to the mass transfer of people with developmental disabilities (conditions such as mental retardation, autism, cerebral palsy and severe epilepsy) from large state hospitals to community settings. As a result, state hospital populations have declined drastically, from 14,000 patients in the 1960s to a mere 3,700 today. The money to care for these patients, however, has not migrated as well. It should.

While the vast majority of the developmentally disabled in California, some 170,000 people, live somewhere in the community (in group homes, with their families or on their own), a disproportionate share of state and federal funds to care for them remains locked up in five large state institutions. The state hospitals, which care for 2 percent of the developmentally disabled people, receive more than 25 percent of state funds.

AB 896 by Assemblywoman Dion Aroner, D-Oakland, seeks to correct this unfair and inefficient imbalance by closing three of the five state hospitals and shifting proceeds from the sale of these institutions into community programs for the developmentally disabled. The measure also would unify what is now this unequal, two-tiered system, capturing funds previously destined to hospitals and using that money to improve community care. It is a necessary and long overdue reform that unfortunately faces powerful and emotional opposition.

The forces arrayed against AB 896 include parents who, understandably, don't want their children moved from hospitals that have been their homes, in some cases for decades, and the well-organized and well-paid staffs of these institutions. They argue that the patients are too fragile to be moved, that there are no programs in the community that can properly care for them and finally, that many would die if moved. They also fear that the developmentally disabled would join the ranks of the homeless as so many people with mental illnesses did when mental hospitals were closed decades ago.

Unlike the mentally ill, the developmentally disabled are legally entitled to government support. Also, studies of the disabled who have moved out of institutions since 1993 prove that most can live happier, more productive and independent lives outside. Unfortunately, there are not enough programs to support them, in part because so much of the money available, $160,000 per patient per year on average, has been siphoned toward the state hospitals.

Now is the time to make the shift. A study two years ago indicated it would cost the state an estimated $1.5 billion to repair and retrofit aging state hospitals that do not meet fire code or Americans with Disabilities Act standards. Rather than spend money to rehabilitate large institutions for fewer and fewer patients, the state should begin investing in community programs where the majority of the developmentally disabled live and where support is most needed.