Community Placement Calls for a Larger Institution?

As the 20th century hit its midpoint, new ideas were cropping up, including around care for people with developmental disabilities. It was beginning to be understood that services provided in the community were both more humane and less expensive. Superintendent Bowman used the shift in public opinion both to tout Pineland’s successes and ask for more funding, for items like a gymnasium.

“He urged a larger staff to step up the discharge and placement rate: larger federal-aid public assistance grants to help patients who can live outside but can’t earn their way: a diagnostic center to help courts avoid mistaken commitments to the Pownal hospital: and more operating facilities at Pineland, including a gymnasium.” (Lewiston Daily Sun, February 16, 1961)

Newspaper clipping from the Lewiston Daily Sun, February 16, 1961, page 1 – Headline: Pineland Is Aiding The State – Dr. Bowman Tells of Rehabilitation at Pownal Hospital – Needs More Help — Lewiston Daily Sun, February 16, 1961

Even as a new infirmary to “house 134 totally dependent patients” was dedicated, Governor Reed called for more, saying, “the needs of this and other state hospitals continue to grow and ‘our state government must be looking to the future in preparation for taking care of the trends in hospital population which are developing.’” (Lewiston Evening Journal, October 16, 1961)

Newspaper clipping from the Lewiston Evening Journal, October 16, 1961 – Headline: Dedicate New Infirmary At Pineland Hospital — Lewiston Evening Journal, October 16, 1961

Theme Alert!

Money

From the beginning of the institutional period, the cost of providing care for people with developmental disabilities was both the reason for building larger and larger congregate settings and an excuse for any evidence of neglect or poor treatment that came to light.

Throughout the history of Pineland you can see the frequent requests for more funding. When Pineland was closed a new pool of money was flooded into the community. This followed a series of cuts and the same types of pleas for additional funds that can be seen through the institutional period.

To this day, disagreements over the amount of funding put towards services plague this system. Reimbursement rates and workers’ paychecks, infrastructure and innovative care – the question of “how do we pay for this?” hangs over all the decisions made.

Waitlists

Waitlists have occurred since the very beginning of services. Many people who could benefit from services to live more supported and independent lives instead languish on waitlists.

In the past, superintendents of Pineland used the need of more beds as an excuse to call for a larger institution.

Today, waitlists for services are an ever-increasing problem. Children, despite a diagnosis can’t access the inventions that could change their lives and as a result, their needs often become so challenging that they end up in significantly more restrictive and costly placements than they would have needed if they had gotten the right service at the right time. Young people who have been supported through the school system can find themselves waiting years to access adult services. People in the disability field call this period “the cliff” when youth are without services and supports and many of the skills that they worked so hard to achieve begin to erode and their future feels like it might slip away. Adults who have services learn that they are stuck in poverty, single, or unable to move as their services may be at risk if they make to much money, get married or move. Life decisions that most of us view as our right can mean starting the process of securing services all over again, making opportunities to grow and be fulfilled as an adult also fraught with anxiety.