Mental health cuts hit some hard

Mar 4, 2010 — Times-News

Keren Rivas

Mar. 4, 2010 (McClatchy-Tribune Regional News delivered by Newstex) -- For 35 years, Fred Roberts has worked at the building at 717 N. Park Ave. in Burlington.

In those years, the mentally disabled 55-year-old has done a little bit of everything -- from making deliveries and doing janitorial work to working in an assembly line. The pay is not much, but the fact that he's working is more than enough.

But come March 16, Roberts will no longer have a job at the facility that, for decades, has been a shelter for adults with mental and developmental disabilities. Instead, he and 15 others must choose to retire, work in the community through Vocational Rehabilitation, or not work at all.

The move is the result of a recent $1.3 million funding cut for mental health, developmental disabilities and substance abuse services in the county and has created concerns among those affected by the cut, as well as those who provide services for this segment of the population.

"We'd like them to be able to stay there," said Caroline Roberts of her son, Fred, and the others affected by the cut. "He's happy there. They tell us Fred can do any job. We cannot understand why they cannot switch him" to another program, she said.

Caroline Roberts said her son has been in public work before through the Vocational Rehabilitation program, something that proved counterproductive. He was hired to hold a sign on the side of the road for a pizza place. While he stood in the cold, the person who was coaching him through the program sat inside a heated car.

She said her son has "some limitations," such as a condition that prevents him from being in direct sunlight for long periods of time and a compulsion to eat whatever is in front of him. Roberts said she is afraid her son, who spent seven years in a mental hospital, is going to agree to do something that is not good for him.

"We have a lot of fear as to that," she said, but she added, "We have no other choice."

DAN HAHN, EXECUTIVE

director of Alamance-Caswell Local ManagementEntity,the agency in charge of overseeing how services for mental health, developmental disabilities and substance abuse services are provided, said he understands there is no easy answer for those affected by the funding cuts.

"This is absolutely a stressful time for the system... and for people who have gotten services but will no longer be getting them due to the economy," he said. "They are going to be harmed."

Hahnsaidprogramsgeared to provide services in the area of developmental disabilities, such as OE Enterprises, sustained the most funding loss. Of the $1.3 million budget cut, $1 million had been designated for those programs.

OE Enterprises manages the program once known as Vocational Trades of Alamance County, where Roberts works.

Prior to the Mental Health Reform Act of 2001, the local mental health agency managed the facility. As part of the reform, however, local mental health agencies no longer provide substance abuse and mental health services directly to residents but rather become local management entities charged with authorizing the services and contracting with outside providers.

Hahn said OE took a 17 percent cut, or a reduction of $186,000, which forced the organization to take a harder look at who they were funding.

Kathy Sticksel, OE Enterprises president, said they offer two different programs that provide in-house jobs at the Burlington facility: the sheltered program and the developmental occupational program.

She said that in the past seven or eight years the federal government changed the funding away from the sheltered program. At the same time, Sticksel said, the agency's board of directors decided not to serve clients who came without funding. The agency managed to continue providing the service since it was able to subsidize its cost by using money earned through contract work with outside companies.

But when their funding was cut in December, the organization had to make some adjustments.

STICKSEL SAID THAT IN

the 32 years she's been in the business, 24 of which she has been at the helm of OE Enterprises, she has never been forced to send people home.

Hahn said his office and OE officials are working together with caregivers to place those 16 people in other locations, though he is aware there won't be in the sheltered, structured environment there had been up until this point.

Sticksel said there are options available for those affected, including retirement for those who have reached the appropriate age or placement in a job through Vocational Rehabilitation, a timelimited service that places people in jobs in the community and provides coaching and some but not constant supervision.

Shesaidthepeopleaffected by the cut were "higher functioning" individuals and may have a better chance of succeeding in community jobs. She said OE puts a focus on community-based employment, adding that Alamance County businesses have been very accepting of OE's clients.

Sheila and Bob Smith, who administer the West Hillcrest DDA Home, a supervised facility in Burlington that houses six adults with developmental disabilities, said there has been a push by the state and providers in the past couple of years for adults like their clients to live independently, make their own decisions and work in community-based employment.

And while this may sound good on paper, in reality it sets unrealistic goals for people who cannot function outside a structured environment, the couple said. Four of their clients, including Roberts, will be affected by the cuts at OE Enterprises.

"They have these disabilities for a reason," Bob Smith said. "They were in the sheltered program for a reason."

SMITH SAID SOME OF

their clients cannot boil water or bathe themselves, let alone work in a regular setting. He said minor changes in their routine can disrupt their entire world. If that wasn't enough, he said, clients have to worry about not making too much money or they could lose their Medicaid coverage.

Sheila Smith said many caregivers who fear their loved ones can be abused are considering declaring their loved ones incompetent so that they can be the ones calling the shots.

That's what Loretta Madren did about three years ago with her baby sister, Judy Boswell, who is 62 and has worked in the sheltered program in Burlington for 38 years.

"There were classes that we had, discussions about Judy's goals and plans for her and things that were against what I really felt was good for Judy," Madren said.

Madren said Boswell had a bad experience in the past with community-based placement because she wasn't able to keep up with the other workers. In the end, Boswell had to be hospitalized in the psychiatric unit at the hospital to receive treatment, Madren said. From there she was released to the Smiths' group home, where she currently lives.

Since working in the community is not an option for Boswell, Madren said there is nothing being proposed that would allow her sister to make any kind of money in a supervised environment. She said this is not about the money her sister was making but rather what it meant to have a job.

STICKSEL SAID SHE

doesn't "necessarily agree" with the idea that some of their clients are not able to work in the community. However, she was quick to point out that in the end, the decision on what's best for their clients lies with the clients themselves and their caregivers.

She said they have been able to rehire two of the 16 to work part-time as members of the OE staff. She said they may be able to hire a couple more in the future through their own business opportunities.

Bob Smith said he doesn't understand why the state cannot funnel some of the funds it assigns to Vocational Rehabilitation to the sheltered program. He said it would probably be more cost-efficient since people don't need to be retrained for a job they already know how to do.

Hahn said his agency is trying to make sure the cuts, which come from the state, are absorbed in the best possible way.

"If I had more money in my pocket, it does us no good to hold on to it," he said. "Every dollar available for services we make sure it gets out in the community."

For Madren, nothing justifies leaving people like her sister without any feasible alternative.

"It makes me angry... I am very angry about it," she said. "It's really hurting her and it hurts me that what they're saying to her is 'you are not needed anymore.'"

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