The wrong solution

November 06, 2006|By Harry Yost

If history is any guide, the state's intention with regard to the future of Maryland's four residential centers for people with mental retardation and developmental disabilities is crystal clear. Closed admissions, a steady stream of transfers, aging residents and understaffing have led to ever-decreasing populations at the residential centers. Even S. Anthony McCann, the secretary of the state's Department of Health and Mental Hygiene, said at a recent political forum that Maryland law and the Supreme Court's Olmstead decision require the closing of all such institutions.

On the legal side of this issue, however, families know better, and apparently so does Mr. McCann's boss. In September, Gov. Robert L. Ehrlich Jr. said that Olmstead "did not dictate the closing of institutions. ... For a relatively few, the institution may be the appropriate place and the least-restrictive setting." Families of residential center residents feel hopeful that the governor's remarks were sincere (they certainly were informed) and not campaign banter.

The issue of where to best provide residential supports for people with mental retardation and developmental disabilities is one of life or death for many residents. Experiences in other states that have embraced a "one size fits all" (community placement-only) philosophy to providing care should give Maryland policymakers pause. In 30 states and Washington, D.C. - and in federal reviews - there have been reports of abuse, neglect and death in community settings. The Sun's April investigative series on group home problems in Maryland followed reports dating back to at least 2001 by The Sun and other Maryland newspapers.

Ron Coleman, a former social worker and incident data analyst with the Maryland Developmental Disabilities Administration, who oversaw some community placements during the closure of Great Oaks in Silver Springs, has dire predictions if Maryland is intent on additional closures. Upon studying the state's internal data, he recently predicted, "If Rosewood is closed in the fashion of the Great Oaks experience, medically fragile residents, and those individuals who are dangerous to themselves, will die in the community at a rate of 400 percent greater than if they stay at Rosewood; 13.5 percent will die within the first 18 month."

Behind the push for "community for all" is a coalition of advocates who support closure of institutions despite objections from families and regardless, it seems, of the end result. The community-only coalition has bought into the social policy of full inclusion (literally, in some cases, as some community-only advocates also provide community-based care and profit from the transfer of residents to their community homes).

Many families favor facility improvement, not closure. Recent state inspections at Rosewood revealed serious problems involving resident safety. Facility administrators and staff quickly addressed these problems to the satisfaction of state inspectors.

"Rosewood's mixed population, about 150 long-term residents who are developmentally disabled living with some 50 mentally incompetent defendants who have been committed to the center by the courts, is the heart of the problem," a state surveyor recently said. It should be obvious to anyone that serious problems will arise when residents who are dependent on their caregivers for every need are forced to live with individuals capable of armed robbery, assault or rape.

Maryland anticipated problems with mixed populations yet neglected to address them. Original plans were to limit court-ordered placements to a manageable 25 people; they now number 50 at Rosewood. Plans to move all such residents to Clifton T. Perkins Hospital Center in Jessup have been scrapped, with costs given as the reason. The state has also ignored Rosewood's anemic staffing levels, with current staff regularly clocking double shifts - a situation that contributed directly to the recent "immediate jeopardy" finding.

In addition to utilizing psychiatric hospitals, such as the Jessup facility, other states, including California and New York, have addressed the concern of mixed populations by serving court-ordered mentally disabled and developmentally disabled residents at specialized facilities dedicated to meeting their unique needs. Other states, such as Idaho and Tennessee, tackled the challenge by splitting their campuses in two, allowing for different licensed programs to accommodate two distinct populations, with dedicated staff, training, licensing and funding for each.

With documented tragedy, dire predictions and more than 13,000 Marylanders needing services, citizens ought to be crying foul. Families of people living in residential centers and those who have been forcibly moved are crying, but we haven't stopped fighting. Maryland's most vulnerable citizens with mental retardation and developmental disabilities deserve safe and adequate services. For now, for most of these vulnerable people, those services are best delivered in Maryland's four residential centers.

Harry Yost, the father of a Rosewood resident, is treasurer of Rosewood Center Auxiliary and was appointed to the Rosewood Citizens Advisory Board by Gov. Robert L. Ehrlich Jr. His e-mail is

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