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Return to the bad old days?



Last modified: Thursday, April 14, 2011
Thirty-one years ago this month, we opposed one another in representing the residents of the Laconia State School and the state in Garrity v. Gallen, the lawsuit challenging conditions at that institution and the lack of adequate, community-based services for people with developmental disabilities.

While the legal interests of our clients diverged, the parties agreed on goals of the lawsuit: to redress inhumane conditions, end years of segregation and develop a system that enabled individuals to live and thrive with supports in the community.

There were parents who were understandably fearful that if the institution closed, there would be no place for their sons or daughters to go. Fears lessened and virtually disappeared as community placements occurred, families saw that individuals were far better off in the community, and state officials pledged to maintain comprehensive community services.

When the Laconia State School did close in 1991, New Hampshire was recognized as the first state to operate a system without an institution. There were also financial benefits; community-based services were less expensive than an 'improved' and fully funded institution.

Moral obligation

The state's pledge to maintain a community system was based on legal mandates and the fundamental moral obligation of government to provide support to those who need it throughout their lives, an obligation that has transcended political forces in New Hampshire.

The state's groundbreaking developmental services statute was signed in 1975 by conservative Republican Gov. Meldrim Thomson (though little was done to implement it, necessitating the lawsuit). Laconia State School was closed on the watch of Republican Gov. Judd Gregg. The Katie Becket law for children with significant disabilities was championed by President Reagan, and President George H.W. Bush signed the Americans with Disabilities Act into law.

More recently, Democratic Gov. John Lynch signed SB 138 ending the waitlist for services.

Three decades later, this pledge and the mandates from the Laconia lawsuit are threatened by the House budget bills which risk recreating the conditions that led to the suit.

The extreme cuts terrify elderly parents unable to care for their adult children with disabilities. Younger parents face the prospect of having to quit jobs to care for their children who will no longer qualify for services once they turn 21.

The cuts will also deprive supports to individuals currently relying on them.

Cost-effective model

Statements by House lawmakers show misconceptions about the state's community-based system. For example, one legislator claimed that funds have been wasted on bloated bureaucracies and hundreds of excessively highly paid top and mid-level managers leading privileged lifestyles, while only 37 cents of every dollar goes to client services. Nothing could be further from the truth.

First, the state's service model is among the most cost-effective in the country, relying mostly on families and adult foster care over staffed group homes or institutional settings.

Second, except for one or two minuscule rate increases, there have been no rate increases in the past 16 years for the community system, despite increasing costs - with the result that:

• Wages of direct support staff have remained stagnant at unconscionably low levels, causing significant workforce issues,

• Huge waitlists have developed, forcing needy people to wait years for needed services, with the exception of a recent two-year period, and

• The supervisory structure to provide oversight, training and support to field staff has been gutted. The amount allocated to administration is 8.6 percent, well below standard.

The average amount New Hampshire spends annually for persons on the 'developmentally disabled Medicaid waiver' dropped from $55,000 to $44,000 from 1994 to 2010, despite increased costs, and well below the $200,000 cost of institutions, an alternative families may be forced to choose.

Dwindling state support

New Hampshire's level of fiscal effort - funding for developmental services vs. New Hampshire's wealth - dropped from 10th to 32nd from 1995 to 2010.

The truth is, there is no fat to trim; we have been cutting into bone for years.

Commissions and legislatively created task forces have been recommending funding increases in critical areas. Yet on top of a 16-year funding and service erosion, the House wants to cut 14 percent more funding in 2012 and 20 percent for 2013, causing nearly 70 percent (7,000 of nearly 11,000) of individuals to lose their services or experience severe cutbacks.

Many will suffer a loss of employment along with many parents who will have to remain home.

Additionally, about 1,100 support workers will also lose their jobs.

There will be severe human costs to individuals as we return to some of the conditions that led to the Laconia suit - little support to individuals and families, diminishing independence, and increased victimization, exploitation and other forms of mistreatment, including preventable deaths.

We urge the Senate and the governor to do what is necessary to maintain the system so that all eligible individuals are properly supported. It would be a tragedy to return to a world that was left behind more than a quarter of a century ago.

(Richard Cohen and John MacIntosh represented the residents of Laconia State School and Bill Glahn the state defendants in the lawsuit, which was filed in April 1978 and decided in 1981.)