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ACT figures it needs an estimated $36,000 in funding to add a staff person who would work more with short-term Liberty Island residents, Mitchell says. After a few days, the client could move either into a regular bed at Liberty Island or on to another facility. "At least that will give us a little time," Mitchell says. It would benefit Liberty Island, an already overworked ACT team and the mentally ill.
Mitchell also would really like the state legislature to vote to fill that $250 gap. It would be far cheaper, he says, to subsidize these people at $250 a month and keep them stable, rather than to keep paying for crisis hospital visits that are $550 to $600 daily.
Bernadette Moreno has been at Liberty Island for three months, coming off a five-month stay in jail. The 35-year-old had decided to stop taking the medication for her bipolar condition because it made her sleepy and she wanted to do well at her new job.
This got her into trouble. When she stops taking her medicine, she gets to thinking she can do anything, and that's not always good. "I'd been up for seven or eight days straight," she says, rubbing one arm. "This [Pasadena] police officer, he started asking me questions. He grabbed me. I shoved him away from me. Then I ran."
The police chased her. "They beat the tar out of me," she says. She remained so angry that when they put her in the holding cell, she pulled the ceiling down on herself. She was charged with assaulting a police officer, destroying public property, resisting arrest and creating a public disturbance.
"At the time, pulling down the ceiling and fighting the police department seemed like a good idea," she says ruefully. "I got five months for it."
Her mom got her set up at Liberty Island, and she likes it there because "there's stuff to do." She knows she shouldn't be in charge of her own medicine.
A major part of the support that Liberty Island provides is that staff members watch residents and get them to a doctor if they're about to fall off track. Even those who are taking their medication may need it adjusted. "You try to get to them early so they're not in the hospital that long. We ask them if they'll go in voluntarily," executive director Johnson says. "Sometimes we're doing commitments."
As she moves through the hallways, it's clear that the residents like Johnson. She gets a special cheer at lunch because in addition to the regular healthy meal mandated by the state, they've brought in pizza to reward the residents for helping them pass their latest inspection by the Texas Department of Human Services.
A licensed vocational nurse, Johnson got her start in the assisted-living business after she volunteered at a mental health facility and was devastated by the squalid conditions. Her mother, Almether Johnson, and her aunt helped her establish a home for the mentally ill.
They put together $5,000 from Johnson's life insurance, $1,200 from her income tax return and $4,000 from the aunt to get started. Her first patient took Johnson's bed, while Johnson slept on the couch.
In November, she'll have been in business 18 years.
"Everybody has to have a purpose in life, and they have to feel worthwhile," Johnson says. And when people start to feeling better, they want to get a job. "We've got to give them real work opportunities, to have a chance at the real all-American dream."
But there are obstacles. Getting a job is a success, but patients who make more than a certain small amount have their all-important Medicaid benefits pared back and eventually dropped. That's a scary prospect that stops many of the mentally ill from applying for that first job.
There have been massive cutbacks in the job-training programs offered through MHMRA, and some of the private companies prey upon the mentally ill, ACT leader Mitchell says.
"When Medicaid came in, Medicaid was supposed to be this big panacea of extra money, but once the legislature saw it, they decided well, the mandate every year has been 'Make it up with Medicaid.' " Problem is, Mitchell says, Medicaid does not cover vocational training.
His "dream" model is Minnesota Diversified Industries out of St. Paul. It employs more than 500 people, dedicates at least half of its positions to people with disabilities including the mentally ill, and is a multimillion-dollar operation with relationships with other companies such as 3M. Employees assemble CDs, cassette tapes and filters used in medical labs.
Salaries are good, averaging $9 an hour, and workers get medical insurance, vacations and tuition assistance. "They do a lot of things to make it more tolerable for people with mental illness. They don't worry about people talking to themselves as long as people still produce and still work."
Maverick Chevalier was not so fortunate. As "trainees," Chevalier and other men were sent out in teams to clean offices. They worked 25 hours a week (five days a week, from 9 a.m. to 2 p.m.) and were paid a $30 "stipend."
Even though Mitchell is outraged at the practice, Chevalier was satisfied. He hadn't worked in years, he says, and "I needed something I could do, something to occupy my time."
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