GNS: Push to Downsize NY's Mental Hospitals Lauded, Called 'Overdue'

Push to Downsize NY's Mental Hospitals Lauded, Called 'Overdue'

By Jessica Bakeman Gannett News Service   December 3, 2012


ALBANY - Gov. Andrew Cuomo issued an executive order on Friday advancing the state’s efforts to place... disabled people in integrated, community-based settings rather than state institutions.

Cuomo’s order created a cabinet that will design a plan for how to implement federal law that aims to prevent disabled people from being segregated from the general population, both in where they live and how they spend their days.

The cabinet, which includes officials from state agencies dealing with the disability community as well as several of the governor’s top aides, will present a plan to Cuomo in May. Roger Bearden, who Cuomo last year appointed chair of the Commission on Quality of Care and Advocacy for Persons with Disabilities, will serve as the cabinet’s leader.

Developing a plan to integrate disabled people was one of Cuomo’s goals in his State of the State speech in January.

“The State of New York is committed to the principle that people with disabilities should have access to community-based services, accessible housing with appropriate supports, and employment opportunities that enable them to live productive lives in their communities,” Cuomo wrote in the executive order.

Disability advocates lauded Cuomo at a meeting Monday but lamented that they have been waiting years for the move.

“I’ve been sitting here for 10 years - many of us have,” said Harvey Rosenthal, executive director of the state Association of Psychiatric Rehabilitation Services. “And frankly, we’ve been met with a lot of disappointment in terms of getting real measurable action, real progress.”

In 1999, the U.S. Supreme Court ruled that the Americans with Disabilities Act prohibits unjustified segregation of disabled people. The Olmstead decision, as it is referred, requires states to provide disabled people with necessary support and services “in the most integrated setting appropriate to their needs, considering available resources.”

In 2002, New York passed legislation to create the Most Integrated Setting Coordinating Council, a group that was tasked with designing an implementation plan. Little has been done since then, members said.

The council met Monday in Albany.

“It’s been a long series of stumbles and delays and apathy,” Rosenthal, who is an original council member, said later. “We never really had a real energy behind it - and the energy for something like this has to come from the governor.”

Cuomo’s deputy secretary for health and human services, his counsel and his budget director will serve on the cabinet. That lineup represents the kind of administrative power that has been lacking in past attempts to comply with the law, Rosenthal said.

“That signals a real commitment we’ve never had,” he said.

DJ Jaffe, executive director of the Mental Illness Policy Organization, based in New York City, took issue, though, with the lack of representatives on the cabinet who have expertise in criminal justice. He said some of the New Yorkers with the most serious mental illnesses are behind bars.

“To improve treatment for the most seriously ill, the criminal justice system knows more than the mental health system and has to be at the table,” Jaffe said in an e-mail. “The lack of their participation is what has led to there being more mentally ill incarcerated than hospitalized in (New York).”

If the state does not comply with Olmstead requirements, it could face legal consequences from the federal government. The Obama administration has already sued several states for violations.

According to the federal law, the most segregated settings for people with disabilities would be state or private hospitals, adult homes or nursing homes, where residents would live only with others who have disabilities. The most integrated settings would be independent or supported apartments.

The law also addresses how people with disabilities spend their days. Rather than participating in a day program aimed at teaching independent living skills or holding a job in the community, some people with disabilities perform tedious tasks for below minimum wage.

Bruce Darling, executive director of the Center for Disability Rights, Inc., which has offices in Rochester, Geneva, Corning and Albany, addressed Bearden, the cabinet chair, at the Monday meeting.

“Make sure that the members of the cabinet are reaching out to the disability community and the disability-led organizations,” he said, “so that others don’t actually rule the day and that people who have disabilities have a real voice in this process.”