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Unlike state schools, private providers outsource any additional medical or therapeutic services. Group home residents receive what a Medicaid case worker allows, or only what Medicaid will pay.
More than half of the Texans with the most severe mental retardation are served in state schools, and "that's exactly the way you'd think it'd be," says Jim Miller, who has a 39-year-old son in Denton State School.
"That's the population [private providers] know they can't profit from," he says.
Still, legislators and advocate groups for the mentally retarded and physically disabled push hard to get state school residents into private homes, to integrate them into "the community," and Trevor is exactly the kind of patient that private homes covet. He's young, independent and healthy.
His parents, however, have seen how Trevor fared in group homes and private care.
Before he moved to Richmond, Trevor was kicked out of 13 different private facilities in four months, getting drugged, robbed and beaten along the way.
"He has the mental capacity of a fourth grader, but he's not stupid," says Trevor's father, David Falk. "He figured out that if he didn't like a place, all he had to do was tear it up and they'd send him to the streets."
Trevor escaped once from Richmond State School.
At dusk one evening, he slipped out of his room and strolled across the school's sleepy if not serene campus. He walked past the main gate and security booth and crossed a wide open field, crawling underneath a wooden fence that borders the school's southern edge.
He made it about a half mile down the road before a couple of state school employees caught up with him in a van and took him back home.
"There's so many staff people in and out that he never gets very far," says Linda Falk. "Staff will see him, whether they're on the clock or off the clock, and pick him up and bring him home. Or they realize he's gone before he's out the gate."
The superintendent of Richmond, Al Barrera, gushes about the residents' freedom to roam the school's campus. There isn't a main building and almost all the structures are single-story, nearly hidden underneath the clusters of trees that dominate the campus. Residents walking around the sprawling green spaces and small, 1960s-era brick buildings give Richmond the slight feel of a private university during a summer semester.
"I have seen so much change in the last ten years," says Barrera, who took over the school in 2000. He's driving a golf cart through the campus, directing a tour, and his first stop is a covered arena used for therapeutic horseback riding. "It's not like the old days where you come to a state school and stay here for a lifetime."
The place is hardly a school anymore. When it opened in 1968 — nine of Texas's 13 state schools opened in the 1960s and 1970s — most of the residents were young teenagers. State legislators in 2001 stopped the enrollment of children younger than 22 without a court order, and the minimum age has since risen to 25, according to Cecilia Fedorov, a spokeswoman for the Department of Disabilities and Aging, the agency that regulates state schools and group homes.
The average age at Richmond today is 46, with no resident younger than 17, and statewide, only 3 percent of the 4,600 state-school residents are younger than that age.
Today, more of the mentally retarded never go to an institution, or are only there for a while before moving on.
"In the '60s and '70s, there were no community services," Barrera says. "Today's parents are being given more options for services, with the state school being the last option of resource."
The school's newest housing "cottages" were built in 2001. The women who live in one of the cottages are all older than 30, but the rooms could belong to young girls. Pink bedding is a favorite, with pictures of movie stars and unicorns plastered on the walls.
The population at Richmond, like other state schools, has steadily dwindled in the last 30 years, with enrollment peaking in 1980 at about 1,400 residents. Twenty years later there were about 700 residents at the school, and today, the population has dropped to around 480.
"I think that speaks well because we were able to place people in the community," says Barrera, who parks the golf cart in front of a building that houses the school's "Forever Young" program, for residents older than 50. "When there's money in the community, our enrollment is down."
Fedorov adds, "I don't think it will ever go back the other way."
It costs the state about $125,000 per year to care for each resident in a state school, and Texas spends about half that on each person in a private home.
"There have always been people who want to close state schools, and there's one factor that plays into it in a very significant way, and that's the cost factor," says Charles Ferguson, who has a 53-year-old daughter in Denton State School. "But it's a pretty good place. My daughter lives on a campus, in a community. If she were living in a group home, she wouldn't be able to get out of that house."
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