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State University of New York Press - Paul J. Castellani

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315 pages

English

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Public institutions for people with developmental disabilities continue to operate within New York State, although their very existence has been condemned, and public policies directed their complete closure by the year 2000. From Snake Pits to Cash Cows investigates why these institutions persevere despite virtually universal predictions of their demise. Paul J. Castellani's provocative account spans the years 1935 to 2000, describing decades of conflict and confusion about the role of public institutions. This book demonstrates how and why a convergence of operational, fiscal, and political crises in the mid-1970s resulted in a series of agreements among adversaries that radically changed the political landscape, and reversed the plan to close all public institutions. He also shows why New York's experience has implications and lessons for the study of public policy in the area of developmental disabilities services and for understanding Medicaid policymaking, intergovernmental finance, and human services administration.

List of Tables

Acknowledgments

Introduction: The Perseverance and Vitality of Public Institutions

Part 1: Drift and Conflict

1. Fault Lines: 1935 to 1945

2. Babies and Buildings: 1945 to 1959

3. Planning: The Rhetoric of Public Institutions and Community Services

Part 2: Sweeping Away the Old Order

4. Bonding and Construction: The Foundations of Public Institutions

5. The New Politics of Mental Retardation

6. Willowbrook and the Medicaid Intermediate Care Facilities for the Mentally Retarded Program

Part 3: The Big Bang

7. Creating a New Universe of Developmental Services in New York State

8. Deinstitutionalization: Reorganizing and Refinancing Institutions and Community Services

Part 4: Closing and Not Closing Institutions

9. Closing Institutions: The Right Thing to Do

10. Rebranding the Cash Cows: Not Closing Institutions

Conclusion: From Snake Pits to Cash Cows

Bibliography

Index

Sujets

USA

United States of America

Public administration

Social work

Region

Regional

États-Unis

Informations

Publié par	State University of New York Press
Date de parution	01 février 2012
Nombre de lectures	0
EAN13	9780791483312
Langue	English
Poids de l'ouvrage	1 Mo

Informations légales : prix de location à la page 0,1698€. Cette information est donnée uniquement à titre indicatif conformément à la législation en vigueur.

Extrait

From Snake Pits to Cash CowsFrom Snake Pits
to Cash Cows
Politics and Public Institutions in New York
PAUL J. CASTELLANI
STATE UNIVERSITY OF NEW YORK PRESSPublished by
State University of New York Press, Albany
© 2005 State University of New York
All rights reserved
Printed in the United States of America
No part of this book may be used or reproduced in any manner whatsoever without
written permission. No part of this book may be stored in a retrieval system
or transmitted in any form or by any means including electronic, electrostatic,
magnetic tape, mechanical, photocopying, recording, or otherwise without the prior
permission in writing of the publisher.
For information, address State University of New York Press,
90 State Street, Suite 700, Albany, NY 12207
Production by Judith Block
Marketing by Fran Keneston
Library of Congress Cataloging-in-Publication Data
Castellani, Paul J., 1942–
From snake pits to cash cows : politics and public institutions in New York /
Paul J. Castellani.
p. cm.
Includes bibliographical references and index.
ISBN 0-7914-6439-3 (hardcover : alk. paper) — ISBN 0-7914-6440-7 (pbk. :
alk. paper)
1. People with mental disabilities—Institutional care—New York (State)—
History. 2. Developmentally disabled—Institutional care—New York
(State)—History. 3. State Hospitals—New York (State)—History. I. Title.
HV3006.N69C37 2005
362.2'1'09747—dc22 2004014225
10 9 8 7 6 5 4 3 2 1To DonnaContents
Tables ix
Acknowledgments xi
Introduction The Perseverance and Vitality of Public Institutions 1
Part 1 Drift and Conﬂict
Chapter 1 Fault Lines: 1935 to 1945 19
Chapter 2 Babies and Buildings: 1945 to 1959 41
Chapter 3 Planning: The Rhetoric of Public Institutions
and Community Services 67
Part 2 Sweeping Away the Old Order
Chapter 4 Bonding and Construction: The Foundations of
Public Institutions 91
Chapter 5 The New Politics of Mental Retardation 109
Chapter 6 Willowbrook and the Medicaid Intermediate
Care Facilities for the Mentally Retarded Program 129
Part 3 The Big Bang
Chapter 7 Creating a New Universe of Developmental Services
in New York State 155
Chapter 8 Deinstitutionalization: Reorganizing and
Reﬁnancing Institutions and Community Services 179
viiviii Contents
Part 4 Closing and Not Closing Institutions
Chapter 9 Closing Institutions: The Right Thing to Do 211
Chapter 10 Rebranding the Cash Cows: Not Closing Institutions 241
Conclusion From Snake Pits to Cash Cows 269
Bibliography 283
Index 297Introduction ix
Tables
Table 5.1 New York State: Nonagricultural and Government
Employment 127
Table 6.1 Sources of Revenue of the Mental Hygiene
Services Fund 146
Table 8.1 Census of Residential Alternatives: 1975 to 1986 184
Table 8.2 Census of Day Service Alternatives: 1978 to 1986 184
Table 8.3 Developmental Center Per Diem Reimbursement
Rates: 1975 to 1987 208
Table 10.1 Devursement
Rates: 1987–88 to 2000–01 266
Table 10.2 Medicaid [PIA] Contribution to the General Fund 266
ixAcknowledgments
Hundreds of people in public and private organizations around the country,
especially in the New York State Ofﬁce of Mental Retardation and
Developmental Disabilities, described, explained, and gave me unexpected insights on
the features of policy and practice covered in this book. I risk leaving out
thanks to many if I try to list them all.
Several individuals provided support at crucial times in the project. David
Braddock, Director of the Coleman Institute for Cognitive Disabilities at the
University of Colorado; Valerie Bradley, President of the Human Services
Research Institute; and Colleen Wieck, Executive Director of the Minnesota
Governor’s Council on Developmental Disabilities, gave me opportunities to
develop early versions of parts of this book. At a later stage, Jim Mansell of
the Tizard Centre at the University of Kent and Kent Ericsson at the
University of Uppsala hosted forums that allowed me to rethink earlier assumptions
and get different perspectives on my research. Frank Thompson, Dean of the
Nelson A. Rockefeller College of Public Affairs, University at Albany, State
University of New York, supplied the encouragement and resources to ﬁnish
the project. Librarians Alan Carter and Paul Hillengas located archives and
documents and recommended source materials I hadn’t considered. Nan
Carroll, Dawn Guinan, and Clare Yates at the Center for Legislative
Development provided a congenial atmosphere in which to work as well as a great
deal of assistance.
Donna Castellani made an enormous contribution in editing the ﬁnal
draft as well as getting me through the many hard parts in this project.
xiIntroduction
The Perseverance and
Vitality of Public Institutions
Images of the future are usually caricatures of the present. They inﬂate
some recognizable features of contemporary life to extravagant
proportions, and out of fear or hope respond to every vagary of historical
experience, as if it were a sign of destiny.
—Paul Starr, Medicine and the Waning of
Professional Sovereignty, Daedalus
Prologue
September 17, 1987 was a clear, crisp day on Staten Island in New York City.
Several hundred people milled about waiting for speeches by ex-Governor
Hugh Carey, talk-show host Geraldo Rivera, and former resident Bernard
Carabello that were to mark the formal closing of Willowbrook. There was
the atmosphere of a college reunion. Attorneys for plaintiffs and respondents,
parents, and various public ofﬁcials greeted old friends and adversaries in the
crowd, gossiped, took care of a little business, and reminisced about
colleagues who had retired, died, or moved on in the twenty-two years since
Senator Robert F. Kennedy charged that Willowbrook was a “snake pit.” It
had been sixteen years since Geraldo Rivera’s televised exposé and ﬁfteen
years since parents sued the state in federal court for relief of the appalling
conditions at the institution whose name became synonymous with abuse
and neglect.
When the ceremony got underway, the speakers recalled victories and
setbacks in what became known as the Willowbrook Wars and declared that
other public institutions like Willowbrook should be closed. Earlier that year
12 From Snake Pits to Cash Cows
Governor Mario Cuomo, in his State of the State address, said that in addition
to the already announced closures of Willowbrook and Westchester
Developmental Centers, ﬁve more of the state’s twenty public institutions would be
closed by 1991.
In 1991, toward the end of the round of closures begun in 1987,
Governor Cuomo, in his Message to the Legislature, declared that he was directing
the Ofﬁce of Mental Retardation and Developmental Disabilities to “develop
a long term plan to close the remaining developmental centers.” The governor’s
decision endorsed the conclusion of that state agency’s policy paper, A
Mandate for the 1990s: Closing Developmental Centers in New York State, reﬂected
the positions taken by the major provider associations, advocacy groups, and
public employee unions, and echoed the recommendation of the Chairman of
the State Senate’s Committee on Mental Hygiene “that all developmental
centers in the State of New York be permanently closed by the year 2000.”
Shortly after the inauguration of Governor George Pataki in January
1995, New York suspended the closure of all developmental centers pending
a review of the 1991 decision. The suspension became a “case-by-case” policy
as two previously announced closures were completed, another canceled, and
no others were slated for the remainder of the 1990s.
In September 1998, Governor Pataki announced that the state would build
its ﬁrst new institution in thirty years. The governor said the Center for
Intensive Treatment would protect the public by providing appropriate services in
secure settings for people with mental retardation who violated the law. Those
attending the ceremony in Norwich were reported to be “very pleased” at the
“great news” that the facility would employ more than 200 full-time staff in
addition to the more than 500 construction jobs required to build the center. The
state had already added capacity to secure units at existing institutions and
planned the expansion of facilities for other special populations.
In August 1998, the governor announced to “a beaming mix of state
ofﬁcials, voluntary providers, advocates, families, and consumers” a ﬁve-year
plan to eliminate the waiting list for residential services by adding 4,900 new
beds to the more than 30,000 in congregate residential settings operated by
state and private agencies. Admissions to developmental centers continued,
and at the end of 1999, almost two thousand individuals lived in the
remaining eight public institutions, and the agency’s billing to the federal
government topped $2,000 per day per resident.
The Perseverance and Vitality of Public Institutions
What explains the perseverance and vitality of p