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It is time to recognize reality and close the institution
Monday, February 21, 2000
Pittsburgh Post-Gazette
As Western Center slowly dwindles into extinction, those who have a personal stake in the future of the facility for retarded adults have become more desperate. The poignancy of the moment was underscored recently at a prayer rally on the grounds held by the parents of the remaining 63 patients.
Their prayer is that a seemingly inexorable process can be halted at the 11th hour, and that their offspring can continue to receive dependable care at the Canonsburg institution, which has been their home for many years. The families of patients are fearful -- not only about the frightening disruption in their loved ones' lives, but also about the basic quality of care that will be available in the group homes where they would be housed.
These fears are understandable. After all, change is not always for the good, and many a road to hell has been paved with good intentions. But being fearful is not always the same as being logical. And the closing of Western Center, as painful as it is, has logic on its side.
It is also entirely in keeping with a profound societal change -- now more than 30 years old -- in attitudes toward caring for individuals with mental retardation. In 1966, the year that the Mental Health and Mental Retardation Act was signed, Pennsylvania had some 13,000 residents of state centers. Today the number is approximately 2,100 and falling (the average age is 50 and there are no children, as once there were).
There can be no turning back the clock, no getting going around the fact that the emphasis has shifted away from large institutions to community-based options, a sea change embodied in the law. Today 15,000 Pennsylvanians are housed in group-home settings. Western Center had 650 residents as recently as 1985.
In accounts of this struggle, the Commonwealth of Pennsylvania inevitably ends up being portrayed as the heavy --- understandably perhaps, because Western Center is a state-run institution and the state decided two years ago that it would have to close.
But what the Ridge administration is trying to do -- send the Western Center residents to community facilities --- is a logical response to a consent decree signed by the Casey administration to settle a class-action lawsuit.
The agreement did not specifically call for the closing of Western Center, but it did call for residents to be professionally evaluated and sent to community facilities if that move were found to be appropriate. In fact, all the remaining Western Center residents have been designated as suitable candidates to leave.
If anything, the state has been slow to implement action. On the plaintiffs' behalf, the Disabilities Law Project recently filed a motion concerning why the state has not complied with the 1992 agreement. In the meantime, the parents of the remaining Western Center patients are hoping to persuade a federal court to allow them to intervene in the case.
For the moment, the state Department of Public Welfare is examining its options, but, absent a new legal direction, they are limited. The commonwealth no doubt fears a public relations debacle, but officials need to have more faith in the good sense of the taxpayers.
To keep the remaining residents, as their families demand, is not only contrary to the general tide of opinion in the nation, but is also hugely expensive. The Department of Public Welfare now puts the cost of keeping a patient at Western Center at $271,925 a year. The cost of keeping a patient at a group home, even a person with severe retardation, is many times less.
This makes no sense, especially as nothing precludes residents moving out of Western Center receiving excellent care in another setting (in fact, about 300 have left since 1992). Money is not the problem, fear is. Although deserving of some sympathy, the parents of remaining residents must recognize reality.
At this late date, nobody can seriously ask to maintain a dinosaur; the only legitimate demand is for the current residents of Western Center to continue to receive good care when they move.