Lack of housing traps some people at state hospital
By Anne Saunders, Associated Press Writer March 27, 2005
CONCORD, N.H. -- Ella Drew is ready for her own apartment.
Since leaving the state mental hospital, she's learned to plan meals, shop, clean and organize her time. She's taking medicine for her schizophrenia and she's stopped drinking.
But six months ago, she was told she'd have to wait up to a year for a federally subsidized apartment. While she waits, someone at the state hospital is waiting for her spot at Fellowship House, a small group home.
A recent study found that for 25 percent of the people at the hospital, the lack of community housing -- not their medical condition -- was the biggest barrier to discharge.
It costs $756 a day to keep a person at New Hampshire Hospital. Closing 24 of the 202 beds there and shifting people to group homes would save an estimated $2.4 million a year, according to the study.
Group homes vary from $100 to $280 per day, depending on the level of supervision. Supported independent living is even less, about $32 per day, the study found.
It's a problem around the country, and one that could get worse as President Bush proposes cuts in federal housing programs and Medicaid, which provides health care to the poor and disabled. States, for which Medicaid is a big and growing cost, are looking at their own cuts.
"It's getting tougher and tougher and we're getting worried," said David Miller, senior policy associate with the National Association of State Mental Health Program Directors. "I really do think there are a lot of black clouds on the horizon."
Nationally, state institutions house about 48,000 mental patients, Miller said.
In New Hampshire, the growing population puts additional pressure on the state hospital. Two years ago, the hospital added 18 beds after repeatedly turning people away.
"We see nothing to stop the growth," said hospital Superintendent Chester Batchelder. New group homes and supported housing will be required just to keep up, he said. Without them, "the system will sort of crash around us."
Jails, schools and regular hospitals bear the brunt when state facilities run out of room.
"The amount of tax dollars it costs to treat them in these other systems is vastly more," Miller said. He and others say it's a matter of "pay me now or pay me later."
Batchelder said the hospital expects to admit 1,800 patients this year, double the number in 1988. He calculates the state needs to add 10-12 group-home beds a year just to stay even with demand.
The Department of Health and Human Services' budget included $600,000 toward a new, 12-bed group home, but House budget writers have cut that money from their preliminary budget.
Drew, 49, was once one of the people waiting to leave the hospital. After about six months there, she spent 14 months in transitional housing on the hospital grounds, a program similar to a group home but with more treatment and medical support. At just under $500 per day, it's still one-third cheaper than the hospital.
Four years ago, transitional housing was just that, with the vast majority of people leaving within a year for placements in the community, according to program director Dennis D'Ovidio. Now the average stay is almost two years.
"They come over here with a lot of hope and they have goals they're working on," said Robin Hardy-Groce, a case manager with the transitional program. "The longer people have to remain here, you can see their hopes get dashed. ... We've seen folks stay here for years."
After waiting to no avail for a group home, one woman is considering moving to a boarding house. The staff worries that without support, she faces a greater likelihood of winding up back in the hospital.
What's really needed is a continuum of housing options, according to Fellowship Housing Opportunities Inc., which manages Fellowship House and 41 apartments in the community. Fellowship House is home base for roughly 75 people who stop by to get their medication or seek help in solving housemate difficulties.
"There's still not enough," said Page Cannon, the nonprofit's executive director.
Concord has about one-third of all the state's community-based housing for the chronically mentally ill. Manchester and Nashua have about another third combined and the rest are scattered. The Seacoast has few options. The North Country has three group homes, providing about 26 beds in Conway, Littleton and Berlin.
The 10 Community Mental Health Centers say they could create more group homes if the political will was there.
Cannon and other people who run group homes say the biggest obstacle is Medicaid rates that don't cover costs. With reimbursements at $81 per day per person, adding group homes means losing money.
It's also complicated and time-consuming. Riverbend Community Mental Health in Concord recently added four beds to an existing house. But the beds sat vacant for a year because of licensing obstacles.
State Rep. James MacKay said the system is close to the breaking point. He wants a comprehensive study of the problem and possible solutions, something the state health department supports.
Meanwhile, Drew waits.
She's eager for her own place "so I can do my own chores, so I don't have a lot of people under my feet. I hope I can hear from them soon."
------
On the Net: www.fellowshiphousing.org
www.nasmhpd.org
http://naminh.org/resources-mh-centers.php
No comments:
Post a Comment