An interesting pattern has emerged surrounding the debate about the closure of Mabley Center in Dixon.

This debate is not a new one. But usually the sides taken up in the debate are divided between state and community service providers. This time around, however, the line of argument appears to fall between those with real-world experience in providing services in DD and those who operate primarily with only an abstract or philosophical understanding of the issue.

This was illustrated at the COGFA meeting for Mabley on October 17th. Many, many parents and family members took their stories to the commission. Over and over again they explained that their sons, daughters, brothers, and sisters had been served in the community, but that community providers had been unable to manage their needs. In some cases people had been in and out of community programs multiple times, but ultimately returning to state services because of intensive needs.

The response they receive from those advocating community placement? Your child/sibling will be happier and better served in the community.

If that response seems to you to suggest the listener has failed to hear what was said by the parents, you are not alone. Advocates for closure of Mabley Center repeatedly rely upon information about the developmental disability service systems in other states to support the idea of closing centers in Illinois. What they fail to take into account is the fact that, unlike in those states, the Illinois community system has not been prepared to serve people with intensive developmental, mental health, and behavioral needs.

IARF - the Illinois Association of Rehabilitation Facilities - is an organization representing "over 90 community based providers serving children and adults with developmental disabilities, mental illness, and/or substance use dependencies in over 900 locations throughout the state". In short, IARF represents actual community service providers in Illinois.

In their comments to COGFA they wrote:

...we do not believe the aggressive closure timeline of the developmental centers as recommended by the Department is conceivable.

The reasons the closures are "not conceivable" can be found in IARF's recommendations outlining what would be needed to successfully transition people to the community. Key among these are:

Recommendation 4: Develop community-based capacity to appropriately address the needs and wishes of individuals transitioning to the community. This requires funding to supplement – not supplant existing resources for individuals currently being served in the community.

and

Recommendation 5: Revise existing Community Integrated Living Arrangement (CILA) rates to cover the cost of providing care and clearly identify specialized rates where appropriate. Timely payment must be secured as well.

The board of IARF is comprised of representatives of multiple large and capable community developmental disabilities service providers. Clearly it is in their interest to have people's needs met in the community. They are also acutely aware of the actual state of support for developmental disabilities services in Illinois.

The people and programs with real world experience in providing community services do not support the governor's plan, do not agree with the advocacy groups who support closure. This, if nothing else, should give the legislators and the governor pause.

Tags: Developmental Disabilities, Autism

On Friday the Chicago Tribune published an editorial opinion piece on the Governor's plans to close the Jacksonville and Mabley Developmental Centers in Illinois.  While it is understood that opinion is only opinion, it appears that the author or authors of this piece have either not chosen to research this complex, multidimensional issue before putting pen to paper, or they are working from a political perspective that would prefer to ignore the available facts.  

Several comments within the piece suggest this:

But if he follows through on at least some of these moves, he will make genuine, humane progress on behalf of some vulnerable citizens. (Emphasis added).

The Governor's plan is to attempt to close two facilities and  move nearly 300 of the state's most vulnerable citizens out of their homes and into different settings within four very short months.  Successful community placement takes time, planning and money.  The Governor has allowed for none of these, ensuring that transitions will be abrupt, confusing, and traumatic.  In what way is such an approach to be considered humane?  

The governor's plans would launch an overdue revamp of the state program serving the developmentally disabled…  The governor has started to lay the groundwork for a responsible transition that takes into account the needs of families, guardians and residents, while phasing out an obsolete system.

This is blatantly incorrect.  Governor Quinn has announced no plans to revamp the state programs, has laid no groundwork. What he has announced are rapid, unplanned facility closures due to budget shortfalls.  The timelines he has offered will almost certainly result in the overwhelming majority of the people at Mabley and Jacksonville being moved to other, *larger* state facilities.  This is what happened during the last two closures, both of which offered more than twice the timeline.

Is consolidation of the disabled into a few massive centralized institutions the revamp, the responsible transition the authors are hoping for?

We believe the community system has the wherewithal not only to serve those now housed in state institutions, but to serve them better… State employees of the centers could make the process easier. Staff could support the idea of moving, help match residents with the best possible community placement options and work diligently to assist in the transition.

The mission of the state operated developmental centers has long been to prepare people for transition into the community.  However, responsible advocates for the disabled understand that there are no black and white, all or nothing situations or solutions.  

With regard to the wherewithal of the community system, those directly familiar with the situation know that community placement options have always been extremely limited in Illinois, evidenced by a waiting list of some 21,000 people (a number which does not include the people in the state operated centers).  When openings do become available community providers can choose whom they wish to serve and, understandably enough, they tend to serve people on the community waiting list that do not have the intensive behavioral, sensory, and medical needs of the people served by the state centers.

Indeed, this situation has been further exacerbated by the economic downturn.  Governor Quinn's administration has followed Blagojevich's lead in dealing with disability service providers, withholding and delaying payments until many have been rendered destitute.  Serving people with intensive behavioral, sensory, and medical needs requires a significant investment of resources.  This made identifying appropriate placement challenging in the best of economic times.  For the authors here to suggest, in the current economic climate, that the providers the Governor has already spent the past three years impoverishing will now be in a position to rise up and provide highly specialized services is the height of either ignorance or irresponsibility.

As has previously been mentioned here, there is no question that, ultimately, it is possible for the community to meet the needs of the people in these centers.  This is, in fact, done and done well in other states.  Unfortunately, the Illinois system has not received the adjustments that would be required to make those transitions possible.  

The paramount consideration should be the welfare of the residents now in state care. They're a fragile group, and those with challenging behaviors and intensive medical needs should be treated with caution and sensitivity.

And on this point we agree.  But it is impossible to fathom how responsible advocates, understanding this to be true, could suggest Governor Quinn's slapdash closure "plan" reflects anything resembling caution and sensitivity.

Tags: Developmental Disabilities, Jack Mabley Developmental Center, Autism

As the discussion heats up surrounding Governor Quinn's proposed closure of Jack Mabley Developmental Center it has become important that everyone involved in the discussion have a clear understanding of what Mabley Center is, what it does, and who lives there.

Residential Home

Mabley Center is a treatment center for people with intellectual disabilities such as Autism and Down Syndrome. It is located in the heart of a residential district in beautiful Dixon, a small town on the Rock River in northwestern Illinois that is also known as the hometown of former president Ronald Reagan.

Founded in 1987 and named after noted journalist and humanitarian Jack Mabley, the center is the newest and smallest of the state's Developmental Centers. Far from being the turn of the century institution that people picture from movies, Mabley consists of seven single story group homes on a tree-lined campus.

Mabley was designed to be a state of the art facility that would prepare people for moving into community group homes by providing treatment in a setting that is virtually indistinguishable from a community setting (It is, in fact, smaller than many community settings). The important difference between Mabley Center and many community settings is in the people it serves and the resources needed to serve them.

Specialized Treatment - the Safety Net

Like all developmental centers, Mabley Center serves people with developmental disabilities. However, Mabley Center is different in that it specializes in serving two distinct and unique groups of people with disabilities:

• People with profound vision and/or hearing impairments (people who are blind, deaf, or both); and
• People with behavioral challenges so severe that they present an ongoing risk of hurting themselves and/or others.

Not only does Mabley Center serve these two specialized groups of people, but it functions as a safety net for the community. Specifically, when a person presents with these disabilities to the degree that a community provider cannot serve them it is Mabley Center's role to offer them a safe place to go.

Sensory Impairments

Some people who have intellectual disabilities are also challenged by an inability to see, to hear, or both. Sometimes this is due to disease such as cataracts, sometimes it is self-induced - caused by accident or by self-inury. Often times the inability to hear or see is present at birth, a part of the same disorder that causes the intellectual disability. In all of these cases the challenge to learning to cope with daily life is further complicated by the fact that the person cannot see or hear the people trying to teach her.

Mabley Center is specifically designed to serve the needs of people with intellectual disabilities who are deaf and blind. The walkways have trailing fences designed to allow the blind to find their way independently from place to place on the campus. All of the homes have trailing rails down the hallways to serve the same purpose indoors. Signs are printed in Braille to ensure people can find what they are looking for on their own.

The staff at the Mabley Center are trained in sign language through the Helen Keller National Center for Deaf-Blind Youth and Adults to communicate with those who are deaf. In addition, for those who are both deaf and blind, the staff are trained in a very specialized technique known as contact sign, which involves making signs in the person's hands. This makes communication possible for people who would otherwise be isolated in a dark, lonely world by themselves. Mabley Center is the only state operated center in Illinois that offers these specialized techniques as a comprehensive service.

With the use of these techniques the staff at Mabley Center are able to help the people living there to grow towards independence. They learn to care for themselves, to work and earn money, and gain relationships with others that would not have otherwise been possible. And, with careful long-term planning, significant supports and resources, and a strong collaborative relationship with community providers, some of those same folks have been able to successfully move into community settings.

Severe Behavioral Challenges

For people with severe psychiatric and behavioral disorders in addition to intellectual disabilities the world is often an unfriendly place. People with these disorders may engage in severe physical aggression towards others - including family, friends, and staff. They may hurt themselves, hitting, biting, and cutting themselves. They sometimes cause significant damage to property - both their own and that of others. They may run away, often without regard to the weather, the time of day, or their own personal safety. Often it is impossible for the person to explain why they are doing these things and very difficult for others to understand as well. Such behaviors can make it impossible for the person to safely remain in their family home or their community group home.

When a person comes to Mabley Center with these needs he or she receives comprehensive psychiatric and behavioral assessment and treatment. Successful treatment for these disorders requires specialized techniques and skilled, experienced practitioners. Because behavioral and psychiatric symptoms can sometimes be caused by untreated medical conditions a comprehensive medical workup is performed by a physician and medical staff with years of experience in the field of developmental disabilities. Each person receives psychiatric services at the center performed by a psychiatrist with decades of experience working with children and adults with developmental disabilities. A team of psychologists and behavior analysts conduct functional assessments - a specialized assessment technique designed to determine why the person has been engaging in the behavior, even in those cases when neither she nor her family or friends have been able to do so - and to develop behavioral treatment plans based upon those assessments.

Also integral to this process is a team of highly trained Direct Care Staff. These staff, who provide the day-to-day care of the people at Mabley Center, are specially trained in techniques to prevent challenging behaviors, to de-escalate them when they start, and to ensure the safety of everyone involved when behaviors cannot be de-escalated. Because they provide the day-to-day care the Direct Care Staff are also a vital component in providing the behavioral treatment techniques that are developed from the assessments.

The Goal: Regaining Community Placement

For people in both groups the goal at Mabley Center is always to help them reach the point where they are ready and able to successfully return to the community. This is a mission that Mabley Center takes very seriously. Mabley Center works closely with an array of community providers and between October of 2001 and June of 2008 has placed 56 people in the community - a number nearly half (47%) the size of Mabley's total capacity of 119, and over half the size of it's actual population over the past three years.

The Goal: Keeping Community Placement

In addition to providing direct services for people at the Center, Mabley has a long tradition of offering community outreach services for the purpose of helping people to stay in their own homes. Mabley hosts the monthly Clinical and Administrative Review Team (CART) meeting for the Northwest Network. CART is a group of professionals from Mabley Center and regional community providers that gathers to offer consultative assistance to people who are struggling with behavioral and psychatric concerns while still living in their homes.

In addition, Mabley Center has offered direct Technical Assistance - teams of professionals sent out to provide assistance on-site - to scores of people living in the community over the past 20 years. That assistance has covered a variety of needs, incuding behavioral treatment, training in crisis management, and training on working with people who are blind and deaf.

Mabley Center also works directly with the Support Service Teams to provide short-term stabilization of people with intensive behavioral needs. This is a new process intended to help people in crisis stay in their homes if possible and, if not, to stay out of their homes for as short a time as possible.

Apples and Oranges

In the discussion surrounding closure there have been, and will continue to be, comparisons made between Mabley Center and institutions, between Mabley Center and community providers. The truth is that Mabley Center is something different - a small, specialized program for people with needs they were unable to have met in the community, and working with those in the community to help them remain in their homes. Meeting those needs requires experienced people with specialized skills - doctors, nurses, psychologists, behavior analysts, and specially trained direct care staff. Mabley Center is unique and different from anything else offered in the state of Illinois.

Tags: Developmental Disabilities, Autism

The Numbers Don't Add Up

When Governor Quinn announced that he was going to close seven different facilities across the state, including two developmental centers serving people with developmental disabilities, because of budget shortfalls he released a fact sheet outlining the amount of savings to be realized from the closings. However, it's hard to understand how the Governor arrived at his numbers.

The Governor states closing Jack Mabley and Jacksonville Developmental Centers by the end of February 2012 will save $14.6 million in fiscal year 2012. This is based upon reported annual operating budgets of $10.7 and $27.9 million for Mabley and Jacksonville respectively. These numbers are different than those listed in the FY2012 budget, but we'll use them as they are the numbers reported by the Governor.

The state's fiscal year runs from July 1 through June 30 each year. If both facilities close by February 29, 2012, they will be removed from the budget for the last four months of the fiscal year. This suggests that understanding the savings to be gained is a simple matter of dividing the annual operating budgets by 12 to determine the monthly cost for each center, then multiplying that number by four to find out what the state will save between March and June. I've done that below:

Confusingly enough, using the numbers the Governor provides, the actual savings come out to be about two million dollars less than the Governor projects. This would seem to bring into question whether the math for the rest of the Governor's plan adds up.

Even if we assume the Governor's numbers are correct, there is another significant detail that appears unaccounted for.

Where Did All the People Go?

The Governor's projected savings from the closing of Mabley and Jacksonville are listed as if all of the costs related to operating these programs will disappear the day the doors of the facility's have closed. But the Governor appears to have forgotten one important detail:

The nearly 290 people who live at Mabley and Jacksonville

Whether or not Mabley and Jacksonville are closed, the people living there will continue to need somewhere to live and will continue to require intensive care and supervision. As we've already discussed, the shamefully short timeframe that has been outlined virtually guarantees the majority will move to other State Operated Developmental Centers.

This will mean the populations of the remaining developmental centers in Illinois will grow. Along with that growth of population the cost of operating the other developmental centers will also grow. When Howe closed the costs of of caring for the people who lived there did not simply disappear. Rather, when it shut it's doors at the end of 2010 seven of the eight remaining state operated developmental centers - Shapiro, Ludeman, Kiley, Murray, Fox, and Jacksonville and Mabley - required budget adjustments - increases in the millions of dollars - in the 2011 operating budgets to provide care for the people moving out of Howe.

It Takes People to Care for People

Those increases in operating costs at the remaining facilities were primarily due to the increased personnel each center required. Ensuring the safety and care of people with developmental disabilities is a labor intensive activity.

Skilled labor, to be precise. When Howe was closed it is certainly the case that the state saved costs in terms of the maintenance and care of the facility and its grounds. But of the staff working at Howe, the overwhelming majority moved to similar positions at other developmental centers.

Given that the overwhelming majority - about 73% - of the people who lived at Howe also moved to other state centers, this makes sense. While Howe no longer existed, the people who lived there still did, and still continued to require skilled care. If they close these facilities, most of the operating cost, like the people living in them, can be expected to simply move to other state operated centers. Even if they were to move to community settings, they would still be cared for through state funding. The Governor’s plan doesn’t cut those costs - it simply relocates them.

What's Left to Save?

In fact, skilled care personnel is the major factor for every state operated developmental center. At Mabley the personnel budget for 2012 represents 84% of the cost of operating the facility, and it represents 87% of the operational cost for Jacksonville. When the people at those centers move those costs will not be saved - they will be transferred.

The only costs the Governor can reliably expect to save are those not related to personnel.

If we run the Governor's numbers again with this in mind, this is what we find:

If we take the Governor's numbers as he presents them, cutting the non-personnel related operational costs from Jacksonville and Mabley will save less than $1.8 million. Even if we accept that there will be some savings just by economy of scale it seems unlikely that the savings will amount to much more than $2 million. This is a far cry short of the $14.6 million that is suggested, and approaches amounts described by some as being equivalent to a budgetary rounding error.

It is, in fact, roughly equivalent to the error noted in the Governor's original calculations above.

The proposed closures of these facilities will uproot the lives of nearly 290 people with autism and other developmental disabilities - people who struggle significantly with inconsistency and change - only to move them to another state operated center all for a real-world savings that amounts to 0.004% of the state's $52.7 billion budget.

Shortsighted at best.

Tags: Developmental Disabilities, Autism, Institutions, Budget Chaos

Balancing the Budget on the Backs of the Disabled

Shortly after noon on Thursday, September 8th, 2011 Governor Pat Quinn of Illinois announced the closing of multiple facilities, including two developmental disabilities treatment centers in Illinois as part of an effort to reign in the state's budgetary crisis.

The state of Illinois is in dire financial straits. It has been for several years. Unfortunately it appears that the administration has decided to balance the budget on the backs of its most helpless citizens.

Between them Jack Mabley Developmental Center in Dixon and Jacksonville Developmental Center in Jacksonville serve nearly 300 people with severe developmental disabilities. In Illinois the State Operated Developmental Centers (SODC's) serve as a safety net for providing services to people with behavioral, medical, and personal care needs that cannot currently be met by community providers.

In short, the SODC's serve those people with the greatest level of need.

Closure Does Not Equal Community Placement

In his speech on Tuesday Governor Quinn suggested an upside to the closures of Mabley and Jacksonville - it would result in the deinstitutionalization of the people living there. This concept refers to the movement of people from large congregate living arrangements to smaller, more homelike settings. In general deinstitutionalization is a laudable goal, and one supported by a wide variety of people, organizations and agencies, myself included. Over the past twenty years I have had the good fortune to participate in teams on both the community and state institution side assisting people in transitioning out of institutions.

That said, it is a fallacy at best to believe that the closure of a state facility in Illinois represents an opportunity for community placement for any but a small percentage of the people living in the closing facility.

In the past 10 years Illinois has closed three SODC's: Singer Developmental Center in Rockford and Lincoln Developmental Center in Lincoln in 2002, and Howe Developmental Center in Tinley Park in 2010.

Lincoln and Howe were both relatively large facilities, serving 380 and 247 people respectively, who had to find alternative placement to effect closure. Then, as now, both of these closures were heralded as an opportunity for deinstitutionalization.

But this was only true for a select few. In both cases only about a quarter of the people living at those SODC's - 23% from Lincoln, 27% from Howe - moved to community placement. And where did they go, if not to smaller, more homelike settings?

They moved to another SODC.

In fact, many of the people who moved from Lincoln in 2001 and 2002 moved to Howe Developmental Center, only to be moved again to another SODC when that facility closed last year.

Singer Developmental Center was an edge case. That facility was part of a combined mental health and developmental disabilities program and served only 44 people at the time of it's closure. Further, of those 44 about half were people with significant physical disabilities - a population that providers in the have expertise in serving. This allowed for a larger percentage of people to move into the community from that program - about 34%. But, of course, the remaining people moved to other SODC's - many of them to Mabley.

To place this in perspective with respect to the deinstitutionalization goals it's important to have some context on these facilities and the direction of placement. Singer served 44 people in it's developmental program. It was the smallest developmental center in the state at the time. All of the people who moved from there to other SODC's moved into facilities more than twice the size.

Mabley in Dixon is now the smallest SODC, serving about 90 people. Of those 90 people, history tells us that the overwhelming majority will move to another SODC if the facility is closed in the fashion the governor proposes. For each and every one of those people they will be moving to a larger institution.

Clearly for all but a small minority of people facility closure does not equal deinstitutionalization. For most, it means relocation of institutionalization. In Illinois, closure means consolidation.

Community Readiness

Among people in the developmental disabilities treatment community there is a philosophy: Every person can be served in the community given appropriate resources.

This statement is almost certainly true and yet we see distressingly low rates of community placement coming out of these closures. Key to understanding why is within the last three words of that saying: "given appropriate resources".

SODC's in Illinois serve people with needs that cannot be currently be met by community providers. Most often those needs are behavioral in nature - people who hurt themselves and others at a level of frequency or severity that cannot be safely managed in a community home. The SODC's serve the role of safety net for those people, ensuring they have a place to go when no one else can help.

That safety net remains in place because the state has failed to build a system of community services to take it's place. Community providers are poorly reimbursed, and must navigate an extremely complicated bureaucratic system in order to gain the additional funding needed to serve people with intensive behavioral needs. As often as not, special deals have to be negotiated between the Department of Human Services and the community providers in order to facilitate movement of challenging people out of an SODC and into a community setting. These deals often take a considerable period of time to navigate.

The 25%-ish placement rates achieved by Lincoln and Howe were reached through a relatively long-term plan to close those facilities. Lincoln had 10 months in which to place people. Howe had nearly two years. The governor's plan is to close Jacksonville and Mabley by the end of February 2012, leaving only 5 1/2 months to find new community homes for nearly 300 people. It seems likely that very few of those people will find their way to community homes - fewer even compared to the placement results from Lincoln and Howe.

Community placement is certainly possible, even for people with intensive behavioral needs. It is being done in other states - Wisconsin, for example, has only three SODC's. What it also has, however, is a robust system of community providers resourced at a level that allows them to meet those needs.

The Illinois system is not robust.

This is a well understood fact. Several years ago Illinois established its Blueprint for System Redesign outlining changes needed to facilitate the move from institutional to community services. That plan explicitly indicates the need for increased capacity to manage challenging behaviors in the community as a key component of facilitating placement. Much of what was outlined in the blueprint has yet to be accomplished and those services that have begun - the Service Support Teams, for example - have only recently been started and are still building capacity and experience. Further, while community providers are private agencies, most of the people they serve pay for those services with state funding. The state of Illinois is periodically several months behind on its payment schedule. As a result, many agencies are financially strapped simply serving the people already in placement.

The community is not receiving the support needed to serve the people at Mabley and Jacksonville. Little to no time has been allowed to work through the special deals that sometimes compensate for that lack of support. A number of organizations that are typically in support of facility closure have also expressed concern about the governor's plan for these reasons. That concern is warranted - successful placement must be done with careful planning and appropriate resources rather than with the budget driven haste of the current decisions. The current course of action will ensure that, for most of the people at these centers, facility closure will mean only relocation of institutionalization rather than deinstitutionalization.

Tags: Developmental Disabilities, Budget Chaos, Autism, Institutions

After all of the newspaper articles, rallies, and speeches discussing the need to proceed with a proper budget for developmental disabilities services in Illinois, the legislators ended their special session on Wednesday of this week and went home essentially having accomplished nothing. The best that can be said for the process at this point is that, after all of this wrangling about how services were simply going to end, Governor Pat Quinn was quoted as finally saying “I’m not going to preside over that kind of wholesale slash and burn of human services” in the Springfield Journal Register on Thursday.

Illinois is no stranger to budget struggles. For more of the past several years than I care to remember we've ended the state's fiscal year with no budget, and the legislature going into special session in order to rectify that. Each year this results in confusion and uncertainty for service providers who operate with little to no margin for that uncertainty. This unfortunately means that this recurring poker game played in Springfield every year is played with the lives of our most vulnerable citizens as chips in the pot.

Tags: Autism, Developmental Disabilities

"Every day when you came in to work you'd watch for the sign at the front gate saying 'paychecks are in'. There was a credit union office right outside the gates that did a booming business providing short term loans for the workers while they waited for their checks."

This was a story Tom Bachhuber, a veteran state employee (now retired), used to tell about working at the Dixon State School in Dixon, Illinois, in the 1970's. The State School is no longer in operation, but with the stories coming out of Springfield, Illinois right now, it seems as if those stories from nearly 40 years ago may be coming back around.

Because of the general audience focused upon by major newspapers, it can be difficult to get much information about how the larger budget issues may affect specifically autism and developmental disabilities services. For this reason it seems important to discuss these issues here and make sure that that those who may be affected are aware of the implications of Illinois' budget issues on services. In short, ladies and gentlemen, the situation is dire.

To place these cuts in perspective, a memo sent to DD provider organizations by Lilia Tenity, Director of the Division of Developmental Disabilities on June 11th, 2009, was published publicly on the ARC of Illinois website (scroll down the page to see the memo). In this memo Director Tenity indicates to providers that " The General Assembly recently approved a "50-percent budget" for fiscal year 2010 that cuts a long list of vital services and programs. This budget falls far short of meeting the statutory obligations and needs of the State, and fails to fulfill our basic commitments to the people of Illinois."

She continues: "The legislature's "50 percent budget" cut $2.24 billion from the DHS budget severely impacting our ability to provide vital services to people with developmental disabilities and their families. As a result, we are forced to cut a number of grant programs and consider significant rate cuts to remaining programs."

Director Tenity goes on in the memo goes to list (by funding codes) the grant programs that will no longer be funded as of June 30th. The funding codes and titles are apparently important to bureaucratic systems, but leave something to be desired in terms of description for the rest of us, so we'll clarify a few of them below:

• Pre-Assessment Screening (or PAS) Agencies such as Access Services and PACT, Inc. (among many others) are supported by grant funding in order to connect people with developmental disabilities with services.
• Dental Services, such as those offered by Milestone Dental Clinic in Rockford, Illinois, will no longer receive receive funding.
• "Child Care Institutions" (Program 19D) have been told their funding will be terminated as of October 1st, 2009. This affects children's residential programs such as the Goldie B. Floberg Center in Rockton, Illinois, and Rocvale Children's Home in Rockford, Illinois, among others.
• The Autism Program (or TAP) providers, such as Kreider Services and Easter Seals have been told that they simply will not be funded under the current emergency budget.

In addition Director Tenity's memo goes on to indicate that "Significant rate reductions, in the range of 20 - 30% annually, for all remaining programs including Community Integrated Living Arrangements (CILA), Developmental Training (DT) and Intermediate Care Facilities for Persons with Developmental Disabilities (ICF/DD) services are still under review." Given that Illinois was already ranked at or near the bottom in provision of funding for community services for people with developmental disabilities nationwide, coming in dead last (51st) for number of people per capita served in small residential (6 or fewer people) in 2006 according to the most recent State of State in Developmental Disabilities report the proposed cuts seem all the more poignant and troubling.
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These cuts are of concern to those of us at Forest City Behavior in a number of ways. Most directly, and in the interest of full disclosure, we provide assessment and consultation services to many of the types of agencies mentioned above. In the bigger picture, however, it is important for people to be aware that, due to the already meager funding offered in Illinois (51st, remember) most Autism and Developmental Disability service agencies operate on a shoestring budget in the best of times. Successful behavioral treatment requires the active participation of everyone involved in a person's treatment. It requires healthy, fully functional support agencies. In many cases we are providing behavioral services to support and prevent people from moving out of community placements and into state operated institutional settings. With the bare-bones funding proposed by these cuts this will simply no longer be possible.

If these issues concern you as they do us, it is vitally important that your state legislators be made aware of those concerns. You can identify your representatives by entering your zip code at Illinois State Board of Elections search page.

Tags: Autism, Developmental Disabilities