Status quo is alive and well

Change Same Signpost Showing That We Should Do Things DifferentlThere is a French proverb and a common saying that “the more things change, the more they stay the same.” In other words, change doesn’t affect reality on a deeper level; instead, it cements the status quo.

That certainly seemed to be the state of affairs when I picked up the local newspaper this morning and read that one of my state’s institutions housing people with intellectual disabilities had probably lost its federal funding.

The Austin State Supported Living Center had failed to improve conditions by a federal deadline, so it looks like Medicaid officials will withhold $29 million in funding – more than half the 100-plus year-old facility’s annual budget.

History repeats itself

Unfortunately this is nothing new for Texas institutions. When I worked at the state agency that runs these facilities in the 1990s, many of them were placed on what was called “Vendor Hold” for noncompliance with federal standards. It happened with disturbing regularity.

There are thousands of reasons for the shortcomings of institutions. Among them are that they house some of our most vulnerable people, who are fragile and often difficult to work with. Funding is chronically inadequate, and so direct-care workers are paid little and given minimal training.

Legislators are habitually reluctant to boost funding until something “bad” happens – a resident is injured or dies or an energetic reporter does an expose′ on conditions inside institutions.

But radical changes happen, too

Despite this grim reality, much has changed in how we care for people with intellectual disabilities. Since 1965, there has been a nationwide movement to reduce institutional populations and to establish more community living arrangements. Because of this effort, the number of Americans with intellectual disabilities who live in institutions has declined an astonishing 85 percent.

A dozen states have closed all their institutions and five states have only one in operation. My home state Texas, never known for being progressive, still operates 13 institutions, although it closed two state schools in the 1990s and has radically reduced its institutional census.

Many people argue that all such institutions should be shut down; that they are unnatural living arrangements and that because they are poorly funded, they can never offer satisfactory care.  Others believe there is a definite need for institutions; that some individuals cannot thrive in any other setting.

There’s probably truth to both arguments. But the overarching truth is that our society is still failing to adequately provide for those who are most vulnerable. It’s been going on since time began – the status quo is alive and well.