Rebuild everything in the hurricane area EXCEPT the group homes

[KamaAina]

and other institutional settings.

Why should we waste scarce disaster aid on rebuilding dinosaurs that we will just have to fight to have closed anyway? Let's resettle people with disabilities just like (gasp!) people!

Yes, I am aware that La. is near the bottom in community-based services, and I believe Miss. IS the bottom. But how many times have you heard repukes bellow "Everything changed after 9/11"? Well, everything changed after 8/29, too -- and maybe, just possibly, not all for the worse.

[pilgrimm]

1. What's wrong with Group homes?

I have never heard of soomeone who had an issue with the general theory of group homes.

[KamaAina]

2. They're restrictive institutional settings

Adults with disabilities are adults and should not be made to live under rules similar to those in force at boarding schools. This is the underlying principle of self-determination: that people with disabilities can and should be in control of their own lives, and not their family members, case managers, service providers and the like.

[pilgrimm]

3. The human services must be different from the services we have in MA.

I run a group home and it is far from an institutional setting or Boarding School. There's five guys in the house and they can pretty much come, go and do as they please. It's the law in Mass that people who need services, live in the least restrictive setting possible. The program I work in and all that i know of in Mass is geared toward recovery, so that people can live independently of these services.

[KamaAina]

4. That's why Mass. is the best.

the law in Mass that people who need services, live in the least restrictive setting possible.

I know of no place else that has such a law. Maybe someday we could model a Federal law after it, just like Mass. had Section 766 years before the country had IDEA.

In many ways, the history of the rest of the country is the history of Mass. gone wrong: the rest of us never quite got the hang of public television, HMOs, etc., etc.

[deek]

5. sadly

There is a wide chasm between the law and its implementation. Look at the LRE results in the education system after 30 years.

CA has the Lanternman Act (which Arnold has been trying to bury). Still lots of warehousing going on here.

[pilgrimm]

7. Fortunately there is not such a wide chasm in Mass.

It's far from perfect, but we are lucky to have had some interested parties file law suits and received fair rulings from the courts which have forced the state to meet its obligations.

[jwirr]

15. I heard that one of California's problems is that State

Workers Unions are fighting community based living on behalf of institution workers. They are arguing over where the limited funds should go: community or institutions.

[jwirr]

14. Minnesota also has that law which I think is a federal law but

each state interprets it their own way.

[jwirr]

13. Terri is 48 years old, cannot talk, walk, read, wears diapers,

is fed through a feeding tube, needs one-to-one total care and has uncontrollable seizures. She is a real person. Who would you have make life decisions for her? She lives in a foster home and is happy. I see a lot of people on this topic board who argue for disability rights but most of them do not even realize that there are different levels of ability in most situations. I am all for self directed living but when the person cannot make the decisions who should. I for one prefer the family first.

Minnesota has a rule that group homes cannot house more than 6 people at a time. Some of this type of housing will be needed in NO or they will be sent to large institutions in the area.

[Why Syzygy]

6. My most favorite job ever

was working in a group home for the mentally challenged.
It was not a warehouse. I could not have dealt with that.
They are the sweetest most honest men you could ever hope to know.

I'm not sure exactly what your OP refers to. If it's a people warehouse, I agree, "no". But if they can make home like settings for these people, I believe that should be the solution.

[happyslug]

8. You have various types of Group Homes

From half-way houses for Ex-felons to homes for the mentally challenged. (and everything in between). Most group homes do NOT fall into any one category, here is MY list of types:

1. Half-Way houses, generally for ex-felons, The residents MUST be in at certain times and check in at certain times. The Residents must report where they are going and where they have been (and with whom). Since these generally cover ex-cons who society is trying to integrate back into society the restriction are strict but necessary.

2. Group homes for people who can NOT function on their own but can operate day to day and do NOT need access to constant medical care (Mentally retarded for example, another example are people with severe mental problems that prevents them from being able to live alone). Thus such homes check up on their residents and take them to their appointments. You have common eating arrangements (Both to save money and to make sure the residents eats). The residents must be home at certain times but rarely a problem for such residents need the structure of the group home to survive.

3. Group homes for people who need nursing care on call, but otherwise capable of being on their own. People with severe chronic health problem that do NOT need constant medical attention but may been attention if something goes wrong. Otherwise run like an apartment building, i.e. the residents cooks and eats his own meals if she or he wants to. Resident can leave and come back anytime he or she wants to.

4. More restriction group homes for those people who need CONSTANT medical care but not hospitalization. Access, entrance and exit is restricted do to the need to make sure the required medical needs are meet. These tend to be the most expensive and the most restrictive. These also varies within themselves from treating people with "minor" chronic problems to people under constant medical care for "severe" medical problems (The later more expensive than the former).

5. Group homes for ex-drug addicts trying to quit. Often this is part of a Drug Rehabilitation system. These also can vary from restrictive to no restriction depending on how badly addicted is the drug addict. Often the first few weeks are restrictive just to clean out the system of the drug addict and to break up his or her contacts with other drug addicts (and to keep such non-treated drug addicts out of the home). Later on less restrictive as the hopefully ex-drug addict further adjusts to life without drugs (Generally these are then followed up with AA or NA meetings).

As you can see "Group Homes" vary as to the restrictions imposed on their residents. The restrictions reflect the capability of the residents. Now a constant problem is people being in the wrong level of care. Now the less restrictive the home, the less it costs, but often people end up overstaying (or being assigned) to homes based on what is available as opposed to what they need. Hospitals tend to try to ship people to long term residential medical care facilities, for while these are the most expensive, the people coming out of the hospitals tend to need such high level of care. Once in you can NOT be removed unless the home as a place to put you. Thus people often stay to long in to high a level of care.

One of the great problems of Homes is that everyone knows the best way to help the people in the homes is to make sure the home is as near as possible to the relatives of the people in the homes. The problem is the government agency placing people is the least restrictive home, emphasis the least restrictive home as opposed to the ability of the resident's relatives to get to the home. I have had cases where a Resident in a Nursing Home was put into a Nursing Home 100-150 miles away from their relatives as the "Nearest available least restrictive" Home for the simple reason it had a bed open (and once in the agency does NOT want to move people thus people often are hours away from their relatives and stay that way). For this reason people often do NOT want to leave high costs nursing care facilities to go to less restrictive homes because the less restrictive homes are to far away from their relatives for such relatives to visit on a regular basis.

All of this reflects the need for "contain costs". People forget the vast majority of payments to Nursing Care homes are done by Public Welfare (Medicaid). Medicare will only pay for three days of long term care, after that the payments are made by your states medical Assistance agency (i.e. the Department of Welfare through the Medicaid program). In many states such care exceeds the cash assistance given to people on welfare. Thus when you listen to the debate in the State house on Welfare it rarely mention Cash assistance anymore, the concentration is on containing Medicaid. Before my home state finally put its Welfare handbook on the computer I always joked about the Four - four inch thick (with printing on BOTH sides of each page) "handbook" (YEs we are talking about a foot length of various rules regarding Cash Assistance and Medical Assistance and other, often one time per year, programs to help low income people). Something like 10 pages in those "handbooks" covered who received want, the rest was the various controls imposed on Welfare Recipients (including people in Nursing homes) to minimize costs to the state.

A joke among people in the field after Reagan's famous statement about ending "Fraud and Waste" in the welfare system, was the biggest source of waste was the controls to prevent fraud. The government is the only agency that would but a $10 lock on a 50 cent item, private enterprise would NEVER do that. Private enterprise, knowing it would be cheaper to leave people to occasionally steal the 50 cent items than put it under a $10 lock on that item would NEVER buy the lock. The Government on the other hand is so worried about the image of Fraud that the Government will buy the lock every time. Thus the biggest source of "Waste" in the Government is the costs to prevent fraud. Which do you want Waste OR Fraud?

Choosing between Waste OR Fraud is the REAL choice and the problem with most group homes. The Government is so worried about being "Cheated" and containing costs that every other consideration is secondary to containing costs (And this can include actual medical care). Thus Group homes have to minimized costs to appease Welfare, for the Department of Welfare must show it is containing costs to appease the State Legislature and Congress that DPW is doing everything to contain costs while not actually killing people.

[Banazir]

9. I've lived in group homes, rather than worked in them.

And there's a big myth that needs popping: That level of disability has anything to do with the number of other disabled people you need to live with.

I qualify for some of the more restrictive kinds of group homes, but I live in my own place. There's nothing that a group home can provide that one's own place cannot provide. Things are just funded, usually, in the direction of group homes. Just as they used to be funded usually in the direction of larger institutions.

Another myth is that group homes are great because they're small, or because they look homelike. I have lived in larger institutions and group homes and some of the group homes were worse than some of the larger institutions. They were, however, very nice and well-kept, and the staff enjoyed them. The problem was the amount and kind of control used on residents.

See http://www.autistics.org/library/conversation.html for a description by someone who has lived in institutions including group homes, and someone who has both lived and worked in institutions including group homes. It shows how much being staff can distort reality in terms of what you end up noticing and not noticing about a place.

[pilgrimm]

10. Great link

There's a lot of truth to what the girl has to say about about the group homes. I can appreciate her rebellious attitude too. From what I have seen, most of them are run poorly, the staff suck and they must be terrible places to live, but there are homes that are run well and I don't think that we should throw the baby out with the bath water.

Even if group homes are run properly, they are not for every body and there are plenty of people who would be better off and should be living on their own. However,I do believe that for some group homes can offer things that one's own place can not. Group homes are cost effective, not only for the state, but most importantly for the people who live in them. They also offer peer support, which would be difficult for some to get if they lived alone. I know the guys I work with enjoy each others company and they benefit from living with someone other than staff that can help them when they're in need. I think if given the option, some would still chose to live in a group environment over living by themselves, on their own.

[Banazir]

19. That doesn't make sense, though.

Non-disabled people can choose to live with roommates, or nearby to each other, and it's not called a "group home".

If disabled people want to live with or near each other, or share the same staff, we shouldn't have to move into a group home to do it. There is nothing about living outside a group home that should have to mean we have to live separated from each other, and if there is, that needs changing, because group homes shouldn't exist. "Least restrictive possible" is just an excuse to keep the more restrictive places operating.

[pilgrimm]

20. Sure it does

Many disabled people (I would bet the vast majority) can also choose to live with room mates, or near each other, and it's not called a group home.

I'm not sure what your experience has been, but the people I work with enjoy their home and stay their voluntarily. I do know that there are many other people unhappy in the group homes, but most of the people I know who don't like the group homes simply couldn't survive on their own with out 24hr care. Unfortunately there are not enough people to staff the group homes, never mind giving people 1 on 1 care 24hrs a day.

You make it sound as if out side of a few over protective parents and some misguided social workers, there is this big conspiracy to keep disabled people in the most restrictive settings against their will. My experience has taught me exactly the opposite. The funding (restrictive group homes are very expensive to run)and organization among the various government and private agencies that something like that would take, just isn't there. On the contrary, I have seen people being pushed into dangerous situations and hurt because of it. That's if people even get into a house. Many people with disabilities, and need the assistance of a social worker and/or a group home will often just get discharged to the streets, with no help at all.

And the distortion in perspective that comes with working in these homes also comes with living in these homes. Both residents and staff, but especially staff, need to remain vigilant and avoid falling into an institutional mindset.

[pop goes the weasel]

11. group homes--shudder

When the homes are places that facilitate resident's desires for greater autonomy, they are great. But too many of them are small-scale nursing homes tucked into neighborhoods. The needs of the inmates (let's be honest--they are not residents if they never have any say in their lives) are strictly administered as to whatever standards the home office believes are "normal." Looking "normal" is of more importance than living an enjoyable life. If "normal" adults don't have teddy bears, you can bet that the "functionally 2-year old" adult is not going to get to have a teddy bear. If "normal" adults don't watch cartoons, you can bet that no one at the "home" will get to. Of course, "normal" adults don't get woken up at 5 AM for mandatory crapping and bathing and put to bed at 8 AM after another mandatory crapping and bathing. (And never mind all the "normal" adults who do indeed have toys and watch cartoons and spend time playing "make-believe." Obviously, if the powers that be had their way, they'd all be getting enemas twice a day and forced to live in off-white rooms with beds made with hospital corners.)

Disabled adults, living on their own, use non-breakable plates and built-up utensils if dexterity is a problem--they are not forced to use ceramic plates and regular flatware that ends up forcing them to have to eat everything pureed and poured into a cup. Disabled adults with communication disorders, living on their own, use communication devices and sign language instead of being forced to try to communicate orally.

And there are just plain some people who will never be able to live independently. That doesn't mean that they should be denied the right to enjoy their life to the fullest extent possible. Just because you can't recognize your own reflection doesn't mean you shouldn't be able to eat french fries with your fingers.

I'm sure that others can add to the list of insults and horrors and stupid policies, either as witnesses or victims.

[NMMNG]

12. To heck with that

While our agency stresses "normalization" (a-la Wolf Wolfensberger), they also temper that with a dose of reality. Hence the individuals who live in the group home in which I work have belongings that are not necessarily chronologically age appropriate. Two of them have hope-chests overflowing with toys, a third has a collection of beach balls that she loves to toss around the house, and there is a variety of Disney and other cartoons on VHS for everyone to watch.

They all have "plate guards", which are clip-on rims to keep food from falling off the edges of their plates. They use plastic cups to avoid broken glass, as they sometimes drop or throw the cups. They wear aprons so their clothing does not get soiled when they eat, and their food is chopped or ground by staff as they are unable to chew it sufficiently for safe swallowing.

Meals are real food, not processed, prepackaged slop like you used to get in the school cafeteria. Fresh meat, vegetables, potatoes, real oatmeal and scrambled eggs, and so on. No Banquet frozen entrees, hot dogs and beans, frozen hamburger patties or other such garbage.

There is no "mandatory crapping" at 5am. They get up on weekdays so there is sufficient time for them to get ready for day program. On weekends they sleep in a bit just like anyone else. If somebody wants to take a nap in the middle of the day on the weekend they're free to do so. They retire at night sometime after 10pm meds, though if they are really tired and want to go before that they may do so.

We are not perfect by any means, but we certainly don't run a gulag.

[Traveling_Home]

16. Whose money is it?

Does the money for their services follow them - ie if they move the money goes with them
or
does their 'slot' (money) belong to the agency
ie if they want to move to a different agencies' group home thay have to wait til the other agency gets a slot for them because their slot stays with your agencies group home.

Also do you require that your agency be representative payee for their SSI or SSDAC (Disabled Adult Child) or can they or their family control the money or choose their rep payee

If the slot follows the person and they and their family control their money I have no problem with the issue.

If the agency controls their choices then thay have no choices!

T

[NMMNG]

17. Their money belongs to them

The agency will be representative payee if they choose, but they can have another person be rep payee if they prefer.

If they want to move to another agency they are free to do so at any time. The only thing that might hold them up is if the other agency doesn't have a free opening right away (e.g., if another person must move out before they can move in)

[Traveling_Home]

18. Good to hear

Until a few years ago, in Colorado, the slot belonged to the agency, ie if a person's family moved to a different city in Colorado, the person living in a DD group home couldn't move until a funded slot, not simply an available vacancy, in a group home where there family moved became available. That was because the money did not follow the person. The new place had to have room and a vacant funded slot. Agencies said they had to control the slots to control their budgets. Disabled folks said no. I actually prefer when group homes or their agencies casemanagers aren't allowed to be rep payees. Problem was whenever the SSA beneficairy had an overpayment because of misreporting of income to SSA the disabled beneficiary was always held accountable for the overpayment even though only the agency handled their funds and got paid for doing so. Conflict of interest when agency takes a disabled folks money to pay themselves for services.

Good to hear how your agency is handling it.

T