Institutional vs. Home-based Care

Institutional vs. Home-based Care

The following excerpt from Vermont Governor Howard Dean's testimony before the Senate Special Committee on Aging, 6/20/02, on behalf of the National Governor's Association, calls for states and the US to assure 'most integrated' community settings for its citizens with disabilities. While Gov. Dean is focusing on nursing homes here, adult homes should equally be considered 'last options' for those with psychiatric disabilities."

"Let me talk about the institutional bias in long term care...."Nursing home care is an entitlement under the Medicaid Program while people who would prefer to be on the Home and Community Based Waiver program must wait, often for a long period of time, on waiting lists.

"This means that elderly and disabled Americans are entitled to receive the highest cost and least desirable service, yet they must wait in line for the cheaper and more desirable service. There is something very wrong with this picture....

When it comes to long term care, we put the most expensive and least desirable service first. "This calls for a complete paradigm shift. We need to treat nursing homes and other institutional care as the last option, after all other options have been tried and failed.... Experience has shown that we can serve many more people with the same funding, and serve them in the setting they prefer, when we are able to keep them at home and avoid institutional costs.

"Perhaps more importantly, we can provide a higher quality of life by avoiding institutional services whenever possible. People who need long-term care want it to be provided at home. No one wants to spend their last days or even years surrounded by strangers, separated from their families and friends, enduring constant changes in staff and regular changes even of the people who are their nursing home room.

"Consumers are demanding more alternatives and rejecting institutional care. All we have to do is listen to them and follow their lead. If we do, we will have a better system of care and one, which provides for more people for the same dollars.

"Some people insist we will need more nursing homes. .... We can't afford to protect the status quo. We need to listen to our people and act boldly to develop those services they want and which are more affordable."

This "Mental Health E-News" posting is a service of the New York Ass'n of Psychiatric Rehabilitation Services,

a statewide coalition of people who use and/or provide community mental health services

dedicated to improving services and social conditions for people with psychiatric disabilities

by promoting their recovery, rehabilitation and rights.

To join our list, e-mail us your request and, where appropriate, the name of your organization to NYAPRS@aol.com.

Save these dates!

September 10 - 13, 2002

NYAPRS 20th Annual Conference Celebration

'Now More Than Ever: Hope, Healing and Recovery'

at the Nevele Grande Resort, Ellenville New York

contact: Mary McLaughlin, NYAPRS

1 Columbia Place Albany, NY 12207

(518) 436-0008; fax: (518) 436-0044

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