Could you care for a mentally retarded patient for 278,250$/year without abuse?

Another tale of gross government incompetence.

The Denton State School is the former name of what is now called the “Denton State Supported Living Center”. It is the largest of the 12 State Supported Living Centers currently active in texas. It serves “individuals with severe and profound mental retardation” (1). The Texas State Supprted Living Centers are “operated under authority of the board of the Texas Department of Mental Health and Mental Retardation, a nine-member board appointed by the governor”(2). They are primarily funded by taxpayer money, supplemented with private contributions.

Many of the residents suffer from severe health disorders in addition to their mental disability, which require around the clock attention; more then half of the residents are wheelchair bound (1). The living centers occasionally still refer to themselves as schools in some of their literature, yet their goal is that of caring of patients, not a formal education. The average age of a patient is 47, those patients live in on site apartment complexes, care and activities are available around the clock. Medical facilities, food, and entertainment are all available on site. The facilities employ a staggering amount of workers to care for their patients. Denton SSLC alone has a staff of 1600 to support 580 patients. a 2.76:1 ratio of staff to patients.

At first glance it seems that there can be no reason to want to shut down such facilities. Despite my constant claims that the government cannot manage anything, I have yet again manage to underestimate the sheer magnitude of its ability to mismanage things. It was only in the last moment that I considered searching for actual arguments made by people towards the closing of such centers, rather then imagining what their arguments would have been. Ironically, merely finding strawman arguments meant to demonize those who seek to fix those programs was enough for me to see the truth. I find the sheer magnitude of failure and mismanagement in this program staggering.

The logic is simple, those patients are going to be receiving government disability funding regardless, lets save some money by using economics of scale. The problem is that the government is in charge of doing that, and politicians know nothing about economics or management.

In 2009 it was determined by the DoJ that there is gross abuse of the patients occurring in those facilities; Texas legislators quickly responded by pouring more taxpayer money into ensuring that this is no longer a problem. Yet how effective is it? the 12 facilities treat a mere 4000 patients. Texas current budget shortfalls means it has to cut costs everywhere, it is now proposing a 16% cut, 212 million dollars (3). Simple math shows than that the total cost is 1.325 billion dollars for those 4000 patients; simple math again, shows that each patient costs 331,250$/year in taxpayer money. The SSLCs themselves warn that with that proposed 16% cut (for a final cost of 278,250$/year per patient) they will be unable to comply with the DoJ settlement agreement, that very agreement made to stop what the DoJ terms abuse of the patients. I am utterly shocked and amazed that the government is so incompetent that it cannot manage to properly care for a mere 4000 individuals with this kind of ridiculous budget.

The only plausible way to deal with this is to get rid of the root of the problem, in this case, government management. We need to simply award each family of the patients 250k a year voucher to be used towards a private care facility of their choice. The current facilities shall be privatized rather then shut down outright. If they manage to keep the families as their customers, good for them. If they are unable to show proper abuse free care for a quarter million dollars a year per patient then they have no business being open in the first place.

Not only does this do more towards balancing the budget then the 16% cut, the patients will not have to suffer abuse for it. The reason it should be a voucher and not a check, is to avoid the creation of a perverse incentive as well as to ensure that the money is spent on the patients and not squandered by their caretakers.

Sources:
1) http://www.dentonstateschool.org/about-dss.html
2) http://www.tshaonline.org/handbook/online/articles/sbbts
3) http://www.texasobserver.org/cover-story/disabling-reforms-at-state-institutions

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The amount is obscene. But when government gets as large as it is, numbers lose meaning.

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Daiwa

Join Date 07/2001

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Why am I not surprised or shocked by this?

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