North Carolina ranks 8th in…Institutional Bias??

by Richard Edwards

Recently, United Cerebral Palsy issued its national report card on inclusion, ranking the fifty states on their attempts to serve individuals with intellectual and/or developmental disabilities in community and family settings.

North Carolina ranked 43rd over all. You can read the press release here, and the complete report here. (Warning: pdf) Most notable to me is that NC continues to rank in the top 10 states nationally in terms of the number of people–over two thousand–housed in large institutional settings (16+ residents).

And while several states have closed their institutions entirely (Go, “Bama!), North Carolina is rebuilding ours.

Just this year, Governor Perdue participated in the ground breaking of a replacement for Cherry Hospital in Goldsboro, NC. And recently, the NC Department of Health & Human Services began seeking bids for the reconstruction of Broughton Hospital in Morganton, NC–a project with a total budget of $154,772,802.

Why, in the face of data that supports downsizing institutions as good policy, and the clear example of our neighbor states, do we continue to invest in these types of large congregate settings? Even with a federal DOJ investigation pending against NC regarding our failure to provide community-based living options for people with disabilities as required by the ADA and the Olmstead Decision?

I am not saying that hospitals are not an important part of the continuum–they are. But consider this–for what we are spending to build a hospital in Morganton, we could invest in community hospital beds in Charlotte and Asheville and serve the vast majority of people who are displaced to that state hospital.

My angle is that we do it, not because it’s truly needed, but because jobs are truly needed. Communities–like Goldsboro, and Morganton, and Butner–depend upon the institutions in their community for employment. Not to mention the construction work that goes into maintaining facilities that are falling apart.

And the problem with this seemingly symbiotic relationship is that people with disabilities are stuck in the middle. As long as we continue to divert funds to institutional care, there will never be enough money to support people living in the community. And as long as there isn’t enough support for people to live in the community, there will always be a need for institutional care.

NC’s people with disabilities deserve better than 43rd in the nation.

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2 Comments to “North Carolina ranks 8th in…Institutional Bias??”

  1. Although I have not seen any stats on CAHBA’s efficiency with improving mental health services in North Carolina, my general comment is that our communities need to be able to provide services that are innovative and progressive. For example, Peer Respite Services is an important step in this direction for the state, and needs to be developed and implemented in due haste for our residents. A pronounced increase in the employment of Certified Peer Specialists in the Mental Health and Substance Addiction Recovery areas of wellness support is another cost effective way to enhance treatment and health in our communities.
    The positive outcome data has been available for a number of years to indicate that this community approach supports the growing need of individuals to gain a longer length of recovery time and a better quality of life.

    • Diane–I completely agree. Peer Support is an exciting development for our state, and potentially the most impactful change we’e made in recent years. (I have an earlier post about Peer Support Services as well.) The challenge NC is facing right now is that we have a lot of Certified Peer Specialists–or certainly, more than we’ve ever had–but very little in the way of employment opportunities to put them to work. ACTT provides one position per team, and there are still a few Community Support Team providers out there (but less and less). Our best hope for getting Peer Support Services off the ground will be through the 1915b/c waiver sites, but those will be slow in coming on line. Side note: the National Association of Peer Specialists is holding their annual conference in Raleigh next week–which is a great opportunity for Peer Specialists and other providers to move this service forward in NC. Thanks for posting.

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