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What is it with all these new institutions being built? I thought the move was to get rid of institutions.

Evidently not. In my Dec. 7 blog entry, I told you about San Francisco's bullheaded plan to rebuild the aging Laguna Honda city institution to the tune of nearly $750 million. That's million. ( Read the story from San Francisco Business Journal.)

On the heels of that outrage came news on Tuesday that not only was Kentucky committed to keeping open its Oakwood institution, despite repeated citations for abuse of residents (Ragged Edge news items here and here and here) -- but that it was going to spend "up to $1 million a month" to do so -- at least for the next several months. Amazing. ( Read more about that one here.)

Not to be left behind by the re-institutionalization bandwagon, tomorrow VA Gov. Mark Warner plans to unveil a new budget that includes "$290 million to fully replace two aging psychiatric hospitals and two institutions that house people with intellectual disabilities." (Read the Inclusion Daily story about that.)

What's behind it? Jobs, frankly.


At the Alliance for Full Participation summit in Washington this fall, things got so crowded that I blundered into the wrong session! But even there, I learned something useful: unions don't need to be the enemy when it comes to direct care.

The "public authority" model places direct care workers in a county government labor pool. As county employees, they can of course join a union. Consumers then hire the workers they need directly from the county pool, eliminating the "middleman" (the institution).

The model originated in California and has spread to some other Western states, though not mine, alas. So San Francisco really only needs to look right in its backyard for an alternative.

Oh yes, the governor of Virginia is Mark Warner; John Warner (no relation) is a Senator from that state. Don't say you weren't "warned"! In a similar vein, the name "Oakwood" is spelled "Outwood" in the third paragraph. Freudian, perhaps? "Get our people out!"


Mary Johnson replies:

I guess I was asleep at the wheel as I typed! Thanks, Mark, for catching those typos -- er, brainos. The Outwood-Oakwood snafu can be somewhat explained by the fact that Kentucky has BOTH "Oakwood" AND "Outwood" institutions. Weird, eh?


And another fantasy might be that Laguna Honda would become the model for training professional attendants so that the Union might be a Guild and people could hire/fire them and they'd be highly trained.

San Francisco has excellent training grounds such as the University of California Medical Center whose visiting nurses program could really shine as a way to make in-community care be a showpiece for what needs to be done.

If/as we "free our people" we must be sure not to have happen to them what happened when Reagan just turned the streets into homeless "havens" for PWD a few decades back. This time the money must follow the client (victim/patient/whatever) and the attendants must be well-paid/respected professionals instead of mere bed-pan-cleaners.



I am a homecare worker and part of the SEIU, which has made life better for homecare workers here. We have gotten medical benifits, paid time off, workman's comp, and yearly cost of living raises, none of which we had before. Hopefully, this will translate into better services and less turnover for the clients.

The nursing home workers just joined us recently, and it makes me nervous. They are better paid and get better bennies. I see no reason why we couldn't combine forces and keep them employed by working in homes rather than nursing facilities, and somehow increase all of our pay and bennies to their levels. I'm afraid that instead of working together, they will just work to get people out of homecare and into better paying nursing home jobs. It will be interesting to watch.


The way these people are living are terrible. Something needs to be done.

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