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If the state schools closed, he says, "it'd be a tragedy that few people understand."
Advocacy, Inc. and The Arc of Texas, advocacy groups for the mentally retarded and physically disabled, have led the opposition to state schools in Texas.
In an op-ed piece published by the Houston Chronicle during the summer of 2007, Mary Faithful, executive editor of Advocacy, Inc., wrote, "There are nearly 5,000 Texans locked away in these state institutions...They have few opportunities to see — or be seen by — the outside world. Most people don't even know they exist."
Faithful continued, "[State school residents] are not content to be parked in front of a television or jigsaw puzzle for hours a day; they think they can do more than tear paper into little pieces for a few cents of 'earnings' each week."
The Arc of Texas and Advocacy, Inc. have filed lawsuit after lawsuit against the state on behalf of people who don't get enough funding for the alternative to state schools: community-based services. In 2006, Texas settled a lawsuit filed by the two groups for seven plaintiffs who were waiting for Medicaid waivers for private care. The agreement called for, among other things, increased state funding of community services until at least 2011 and a reduction of state school populations each year.
Another Advocacy, Inc. lawsuit lost by the state was filed in 2006 on behalf of David Robbins, a cerebral palsy patient whom the state tried to move to Richmond State School after Robbins's privatized funding expired.
"I find it very heartless on the part of the state that they've told the families that it is all or nothing, it's an institution or nothing," Steve Elliot, a lawyer for Advocacy, Inc., told the Houston Press in 2008.
After the Robbins victory, Elliot filed about a dozen more lawsuits for patients in similar situations.
The pressure hasn't let up. Representatives from The Arc of Texas pressed state legislators in April to issue a moratorium on all state school admissions until the schools "could demonstrate the ability to keep residents safe and free from abuse, neglect and exploitation."
During the legislative session this spring, the group also "advocated for a responsible reform of the entire long-term services and support system," says Dawn Choate, a spokeswoman for The Arc of Texas.
She referenced a 90-page report released in late 2008 that outlined recommendations that included reducing the number of people in state schools, expanding home-based services as the primary provider and strengthening the community-service infrastructure.
"There's a complete imbalance between funding streams for institutions and community services," Choate says. Texas currently ranks 50th in spending for community services and 26th for state schools.
But other states have already shut down institutions, and doing so hasn't always worked out that well for their former residents.
In March 2002, for example, New York officials closed Seaport Manor, a home for about 300 mentally ill adults, after The New York Times published an article that said the state's homes had "devolved into places of misery and neglect..." The newspaper's investigation, which covered a six-year period, revealed 946 deaths out of 5,000 New York state school residents.
After the closing, state officials "pledged to do all they could to protect the safety and well-being of its [residents]," making sure the community placements were adequate. The Times found that former residents were discharged to homeless shelters and private homes that the state had already cited for patients wearing urine-soaked clothes, being threatened, given the wrong medication, and living in roach- and gnat-infested rooms.
"I feel very constrained," the New York health commissioner told the newspaper. "Where do I put them?"
In Virginia, about the time the Justice Department released its report on Texas schools, Governor Timothy Kaine proposed closing his state's Southeastern Virginia Training Center, home to about 175 mentally disabled residents.
Family members of the center's residents are fighting the closing, because even after Virginia legislators committed $40 million more to community services, options were sparse in private homes. Some families were forced to send disabled relatives hundreds of miles away after high real estate prices caused nearby group homes to close, according to an article in The Washington Post.
In Texas, state schools serve a large population, but pressure from the advocacy groups and litigation have left few people to fight for the state-run institutions, even the people that run them.
"If my son stayed in a group home, he would be 'in the community' only because he was technically in a group home," says Miller, who has the 39-year-old son at Denton. "He wouldn't be integrated in the community. He wouldn't be able to get out and walk across campus like the state school." Miller enrolled his son at the now-defunct Fort Worth State School when the boy was ten, after Miller found him attempting to drink a bottle of Lysol cleaner.
"We already had to keep chains on the refrigerator," Miller says. "After we got over the trauma of what we did to our son — putting him in the school — we realized it wasn't to him, but for him."
Miller visits Denton weekly to see his son, who has a job in the school's workshop assembling packages of boat propellers. Miller can't go to his son's job because his son will lose focus, but Miller has watched video of him working.