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Among those of us who care deeply for and about people with developmental disabilities, I hope to hear emerge a new voice, ours, rising together for the benefit of all, harmonizing with reason, respect and hope, and transcending divisions, giving birth to a new era of creative cooperation.

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Monday, January 18, 2010

RHCs: Keep or Close & Why?

Ever since Gov. Gregoire proposed in her budget to close all of the residential habilitation centers, (RHCs), I have been asking: "What would be gained?"

"Revenue savings?" Hardly! Even though the closure study missed many of the costs associated with "community" services for people with developmental disabilities, it did admit that RHC closures would cost the state money!

Liberation for RHC residents? From what? From their homes and friends? From excellent care, services and activities? How about from safe environments and programs assured by Federal audits ?

RHC residents are not prisoners. Their parents and guardians probably had to struggle to have them admitted. Despite the general rule that people receiving short term admissions (the only ones permitted), will be returned to "community" placements, some guardians are so happy with RHC care and services that they petition for long term residence.

"Better services for current RHC residents?" No.
For 3 reasons:
1) Most still living in RHCs are those requiring the most intensive services, more so than most "community" providers can offer. When DSHS last attempted to close Fircrest, it opened it's doors to "community" vendors who were encouraged to "window shop" for potential clients. Repeatedly and often, "community" vendors were reported to have said, "Keep Fircrest open: our facility cannot take care of these people."

2) RHC s comply with Federal Standards and are required to pass stringent audits; the quality assurance by the state for it's privatized, "community" clients is weaker.

3) Emergency departments, jail or mental hospitals are poor alternatives for people with developmental disabilities whose medical, psychiatric or behavioral conditions escalate beyond their "community" placements' capacity to accommodate them. RHCs provide the safety net and venues for their stabilization, in most cases for return to the "community".

So....what am I missing?
Saskia

2 comments:

  1. POSTED BY REQUEST OF MAUREEN DURKAN

    Testimony before Senate Ways & Means Hearing 1-18-10

    How would you like it if other people were constantly trying to tell you what was best for your child, questioning your parenting decisions?
    Don’t you know your child better than anyone else? People can give you advice, but you as the parent are the decision maker.

    That is how I feel. I am the guardian for my 47 year old profoundly developmentally disabled sister. Sharon is very vulnerable; she has the mental age of about three years old.

    I advocate for only the best for her and I know what that is. I am sick and tired of people who don’t even know my sister telling me what is best for her and that she can get better care elsewhere.

    In most cases this is not true, her care would be downgraded.

    She would most likely have caregivers that are untrained, paid minimally, and have a turn over rate of 75% or more.

    She will likely suffer from a lack of stability as Group Homes, on the average, last only three years.

    She would be at more risk for abuse and neglect, as there is little oversight and audits in community programs, unlike the RHCs where they have strict audits.

    She would not have easy access to medical and dental care.

    She would not have a sheltered work shop. Pathways to employment is the only program offered, now, which benefits those who are higher functioning.

    She would not have a large, protected campus that she could walk freely, and her safety would be at risk, as she has little safety awareness

    She would likely be in a more restricted setting and what would she do all day?

    A move could be harmful to her as she suffered transfer trauma with previous moves.

    She may get very angry and act out if her needs are not met; this is the only way she can tell you. This does not happen at Fircrest where she is treated with dignity and respect.

    Fircrest is where I want her to stay; I believe the RHCs give great care to those who are severely and profoundly developmentally disabled.

    Maureen Durkan RN CCM
    ActionDD Chair

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  2. There is an ARC message that urges those who have lived in RHC’s and now live in a different setting to write their legislators. How deceitfully transparent. The fact is that huge amounts of money are to be made by vendors who support ARC with their dollars. The greed sould be obvious to those who are not blinded by desperate need. To prey on those people is evil. Naturally, if my daughter, Angela were able to live in a setting closer to her family and still get the safe and fulfilling care she now receives at her cottage home at the Rainier Campus at Buckley, she would have already done so and indeed could respond to the appeal. (I would have to respond for her, since Angela at the intellectual, emotional and social age of a 2 year old can neither speak nor write.) In fact, Angela did live in such a setting - twice. Both times she was rejected by her new “homes” because they could not or would not deal with her complex medical and emotional issues.

    The facts are these: The congregate setting offered in the campus like setting of our state’s RHC’s is the most fulfilling and least restrictive available for our state’s most severely disabled population. In many respects it is also the most integrated, because it offers many more opportunities for field trips and group activities on campus than any other venue. The Supreme Court of the US, ruled in the Olmstead decision, that states must offer settings of choice, in the most integrated, least restrictive setting possible. My daughter’s home at Rainier does just that.

    And it costs less. Yes, less. Data provided by DSHS has consistently shown that costs in a “community” setting to provide the same range of services that are provided at the RHC’s are considerably more! Forget, the rhetoric for a bit. Just think logically. It just costs less to provide a single service for several than it does to provide that same service for one. That’s why we have classrooms in public schools instead of a single teacher for a single student.

    We should be offering our state’s RHC’s as centers to provide desperately needed services to all those 18,000 un-served mentioned by ARC. The numbers cited by ARC are so misleading because they imply that somehow, if my daughter and others like her were moved out of her home at Rainier resources would be freed up to serve those 18,000. That is just ludicrous! How can that happen? Oh, I know. Put Angela in a minimally staffed adult boarding home (like those highlighted in the recent Seattle Times Articles) and take the money saved and give it to open more adult boarding homes staffed by minimally paid and trained staff so some RN can earn $1,000,000 per year delegating management of facilities.

    Of course, the fact that since Angela’s medical problems caused two excellent faith based facilities to reject her, means that she would not survive long in such a setting and her untimely death would ultimately shout to the horrible truth that not all people can be so fortunate to fit the mold that the ARC would have us believe our DD population occupies.

    Please do not move my daughter to her destruction.


    Bob Gee

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Comments are encouraged. By sharing perspective, personal experience, both positive & negative, ideas, resources and support, readers can enhance each others&; understanding and we will all benefit.