Obey the Law on the Mentally Ill

Obey the Law on the Mentally Ill
New York Times Editorial July 8, 2010

Nearly a year has passed since a federal court ruled that New York violated federal disability law by warehousing mentally ill people in highly restrictive “homes” that are in some ways worse than the psychiatric hospitals they were meant to replace. The court rightly ordered Gov. David Paterson to give about 4,500 mentally ill people the option of moving into supported housing, where they could live independently with the help of social service organizations. In addition to being morally correct, the ruling was fully consistent with the federal Americans with Disabilities Act, which requires that the disabled be treated in the least-restrictive environment. The state, which has appealed the ruling, should stop stalling and comply. The failings of New York’s mental health system were detailed in two state-sponsored reports dating to 2002. The state Commission on Quality of Care for the Mentally Disabled found a pervasive pattern of neglect in the adult homes and said the owners were driving up profits and the cost of Medicaid by subjecting residents to needless, overly expensive medical treatment. A second panel appointed by then-Gov. George Pataki found that many people confined to the homes did not belong there and proposed a timeline for moving about 6,000 of them into supportive housing. This seemed perfectly reasonable given that New York is nationally known for humane, innovative housing developments where mentally ill people who present no danger to themselves or others manage to live independently. But as the court points out, the state ignored the recommendation.

Judge Nicholas Garaufis of Federal District Court in Brooklyn went over this history in detail in last fall’s ruling. By isolating the mentally ill in highly restrictive homes, he pointed out, the state makes it impossible for them to have contact with the wider community or to learn the social skills that would allow them to live independently. The state argued that obeying the ruling would be too costly. But that explanation was recently rejected by the Justice Department, which was so concerned about the state’s treatment of the disabled that it entered the case on behalf of the plaintiffs. Judge Garaufis dismissed the cost excuse in his initial ruling. “The evidence,” he wrote, demonstrates that serving the mentally ill “in supported housing rather than Adult Homes would not increase costs to the state.” He further noted that the homes were more costly thanks to soaring Medicaid costs. “The overall annual Medicaid costs for an individual residing in an Adult Home, were, on average, roughly $15,000 higher than the average Medicaid costs for an individual with mental illness in supported housing,” he said. The point is that supportive housing is both more humane and, in the final analysis, less expensive. The case moved closer to resolution last month when the United States Court of Appeals for the Second Circuit denied the state’s request to stay the initial ruling while it pursues its appeal. This means that the state will have to devise a mechanism for moving at least some people into supportive housing while the litigation runs its course. The better decision would be to drop the appeal altogether and negotiate a settlement that would bring the state into compliance with federal disability law.

http://www.nytimes.com/2010/07/08/opinion/08thu2.html?_r=1

Melanie Shaw, JD
Executive Director

New York Association on Independent Living
One Commerce Plaza
99 Washington Ave., Suite 806A
Albany, NY 12210
Ph. 518-465-4650
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email mshaw@ilny.org
website www.ilny.org