This article first appeared in the St. Louis Beacon, Feb. 15, 2011 - Mary Vitale of Florissant has a 57-year-old brother in the Bellefontaine Habilitation Center in North County. Betty Coll's 50-year-old son is a resident there, too. Both women are alarmed about what might happen to their relatives if the state decides to close all six centers across Missouri within a decade and place the residents in community housing.
The two women are concerned because language to close the centers is at the heart of Senate Bill 56 filed by state Sen. Scott Rupp, R-St. Charles. He says it's a cost issue. The women say the issue should be quality of service.
"We need to retain habilitation centers for the most severely mentally retarded persons like my brother," says Vitale. "He has multiple physical impairments, medical conditions and extreme behavior. He gets excellent care at Bellefontaine. If they close the center, he probably wouldn't last six months."
Coll, head of the Retardation Association of Missouri, says the same of her son. "He requires one-on-one supervision around the clock. I believe he wouldn't be alive today in a community placement."
Rupp's bill would require the state to have a third party analyze costs and savings, then develop a plan to transfer residents with developmental disabilities "to the most integrated settings appropriate to their needs." The residents could be placed in what's called individualized supported living. Two to three people might live together, in the community, with contracted services to meet their daily needs.
Rupp says his bill actually gives parents and residents of so-called hab centers a voice in planning and preparing for the future of the care for the residents.
He notes that one hab center was closed during the last legislative session because of budget issues.
"Parents and residents had to make life-changing decisions on the fly with a short time to review their options," he says.
Rupp said all hab centers would be closed within a decade under his bill. He also notes that the Department of Mental Health is no longer placing new residents into hab centers. Rupp says that closings would be inevitable "as the aging population passes on, the numbers will fall and centers will close."
Rupp adds that his actions are governed by financial considerations. Even as the population declines in hab centers, the per resident expenditure continues to rise due to fixed costs.
"Some centers are already spending over $500 a day on each resident," he said in a statement. "As the population declines, it could reach $700 or even a $1,000 a day of tax dollars being spent on one individual. The Legislature will find it hard to justify that amount of dollars spent on one individual when comparable services can be provided in the community for thousands less per year."
He says 12 states already have closed all of their institutions, and all services are being provided in the community. He adds that thousands of people in Missouri already are getting services in the community.
"We are attempting to plan ahead for the day that these institutions can no longer function," he says.
Even so, parents or guardians of residents in hab centers say Rupp is missing the point about what they say is poor service in community-based centers.
"If they can't take care of what they already have in the community, how can they take care of habilitation center residents who require more intensive services?" asked Coll, referring to the contractors who run community-based centers.
Representatives of habilitation centers' family associations from across Missouri met in Jefferson City on Tuesday to express their opposition to SB 56.
A spokesperson said the Department of Mental Health has remained neutral on Rupp's bill. In a statement, the agency said, "The question of the future role of the state habilitation centers is a complex and difficult policy issue with strongly held opinions on both sides. It deserves an open and thorough discussion. The department will provide information as requested to assist the Legislature in this important discussion."
Funding for the Beacon's health reporting is provided in part by the Missouri Foundation for Health, a philanthropic organization that aims to improve the health of the people in the communities it serves.
