Proposed state Senate bill would close all Missouri habilitation centers

Wednesday, December 15, 2010
James R. Campbell/Daily Mail A century-old maple tree bears impressive witness to the tenure of Nevada Habilitation Center, which Superintendent Chris Baker says is gradually being closed in favor of a cost-cutting, independent living program of the Missouri Mental Health Department. State Sen. Scott Rupp, R-St. Charles, proposes legislation to plan closing every hab center in the state in favor of community settings.

By James R. Campbell

Nevada Daily Mail

A state senator from St. Charles said Tuesday that he would file legislation to mandate planning for all the habilitation centers in Missouri to be closed and for their residents to be moved into residential housing.

Senator Scott Rupp told the Daily Mail that his bill, to be debated when the Missouri General Assembly convenes Jan. 5 in Jefferson City, comes in response to the statewide "Reboot Missouri" public opinion survey conducted by the Missouri Senate, whose social services committee he chaired.

Rupp's plan comes with a program already underway at the century-old Nevada Habilitation Center, where 28 residents have moved three and four at a time into houses here, and 15 have transferred to hab centers at Higginsville, Marshall, Poplar Bluff and Sikeston to be near relatives.

The Republican said the cost per day for each resident averages $550 statewide and will soon approach $1,000.

However, state Rep. Barney Fisher, R-Horton, disputed Rupp's contention that independent supported living homes are cheaper than hab center dormitories and group homes. "Rupp is closely aligned with the federally funded Missouri Planning Council for Developmental Disabilities and Missouri Protection & Advocacy Services, which are very anti-institution oriented," Fisher said.

"I seriously question the accuracy of the dollar amounts he is putting out."

Hab Center Supt. Chris Baker said recently that 52 residents remained at the Vernon Center dormitory in his administrative complex at 2323 N. Ash St. The 60-bed Benton Center across the street was closed three months ago.

Baker said he had originally expected to decrease his workforce from 315 to 265, but recently decided a smaller reduction may be feasible during the three-year cost-cutting program.

He said the state has been spending $1 million a year to heat, cool and maintain the complex including the Lakeview Center workplace, a warehouse, a staff development and quality assurance building, a power plant and three maintenance structures.

Baker said another building for administrative and developmental services will either be constructed or leased in Nevada.

Rupp (pronounced Rupe) said his bill, to be filed late Tuesday afternoon or today, "creates a transition plan for when there is a bad budget year and they find out, 'Hey, we're closing this and we've got to go somewhere else.'"

Among some 2,500 e-mails received by Reboot Missouri, Rupp said, more than 600 advocated community-based living for the 650 residents being served by the Missouri Department of Mental Health's Division of Developmental Disabilities.

"With the further aging-out of the population, all the centers will be closed in the next 10 years," Rupp said from St. Charles.

There are also hab centers in the St. Louis area at Bellefontaine Neighbors, St. Charles and North and South St. Louis County, although all those except Nevada's have campus group homes with six to eight residents in each one.

Rupp said his proposal is timely in a year when Missouri faces a $900 million deficit and its cost of caring for people with mental retardation, cerebral palsy, head injuries, autism, epilepsy and certain learning disabilities averages $550 a day.

Adding that the per diem expense will probably increase to $1,000, the senator said, "We also need a plan for the employees of centers that need to close because we don't want people to find out they're losing their jobs and have no other option.

"Twelve states have closed all their hab centers and we've seen all across the country that residents are very happy in the community."

Rupp said the state has 500 people on its waiting list for services and could accommodate more of them under his plan. He said he had not yet gauged the bill's support in the Senate.

Fisher said Tuesday that Rupp and his supporters misrepresent U.S. Supreme Court Justice Ruth Ginsburg's 1999 Olmstead Decision, which held that under the Americans with Disabilities Act, individuals with disabilities have the right to live in the community rather than in institutions.

Fisher explained that the ruling calls for community living only if treatment professionals determine that residents are able to live in the community; that the individuals do not object to living in the community; and that the provision of services in the community can be provided without fundamentally altering the way in which the state serves people with similar disabilities.

"The Missouri Planning Council for Developmental Disabilities and Missouri Protection & Advocacy Services have a vested interest in closing facilities because they will subsist at the federal trough," said Fisher. "There is a lot going on behind the scenes."

He said the Nevada Habilitation Center's per diem cost per resident might be over $500 now that its population has been drastically lowered from its capacity of about 160, but that expense was less than $50 per day just a few years ago.

"It's not going to be cheaper in ISL's," Fisher said. "Rupp's figures are not even in the ballpark."

For example, he said the local hab center has a dental office, but dentists who accept Medicaid patients will have to be found here when it closes.

Mental Health Department spokesman Bob Bax said Tuesday from Jefferson City that his agency "always strives to avoid layoffs when we're making any kind of changes and we will continue to do that.

"As I understand, the legislation requires DMH to contract for the development of a comprehensive plan to serve its habilitation center residents in community settings," Bax said.

"At this time, the department hasn't had the opportunity to study the legislation to determine the potential fiscal impact."

He said Missouri hab centers have 2,780 full-time equivalent positions, some of which are usually vacant because of attrition and turnover. The centers' budget this year is for $92 million, said Bax.

A Rupp spokesman said the senator, a former state representative, "pushed through a piece of autism legislation last January that requires insurance companies to provide coverage of evidence-based, medically necessary autism therapies, including behavioral health treatment such as applied behavior analysis.

"He is now widely known for bringing this key piece of legislation to lawmakers and pushing it through into law," the spokesman said.

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