To The Editors:

The editorial entitled “Nowhere to Go” (http://www.bupipedream.com/opinion/44043/editorial-bdc-unfunded-transition/) erroneously conflates two different issues and contains several inaccuracies.

In the context of discussing the closure of Broome Developmental Center (BDC), a residential institution for people with developmental disabilities, the editorial states, “Proponents also claim that patients can be moved to other facilities throughout the state. Forcing patients to move outside of Broome County and away from their loved ones can hardly be called ‘community integration.’ According to the Press & Sun-Bulletin, children in Binghamton would have to receive treatment in Utica, which is around two hours away.”

The issue of sending children for treatment to Utica relates to the proposed closure of the Greater Binghamton Health Center (GBHC), which is a temporary intensive treatment hospital for people with mental illness. It was initially proposed to move all of the children’s beds in that facility to locations in Utica or Syracuse.

Perhaps the confusion relates to the fact that the terms “developmental disability” and “mental illness” both contain “mental”. Perhaps it is due to the fact that both disabilities are addressed under New York State “mental hygiene” law. And perhaps the editors of the Pipe Dream have confused both of these things with Broome County’s proposal to severely downsize, and eventually close, its county-operated outpatient mental health clinic.

In any case, these are two completely different disability categories, and the facilities BDC, GBHC, and the BC Mental Health Clinic, are three completely different things.

Developmental disabilities are permanent, congenital disabilities. They are not in any sense “curable”, nor can their symptoms, in most cases, be eliminated. (Some types of developmental disabilities can be improved if diagnosed early in childhood and intensively treated.) Intellectual disability is a type of developmental disability that makes it difficult for people to learn and adapt. However, most people with intellectual disabilities can learn and adapt eventually, and what they learn, they retain, and can put into practice reliably.

Serious and persistent mental illness, on the other hand, is better understood as a disease process, although it appears to have a genetic component. For many people, mental illness is “relapsing and remitting”; that is, it gets worse, requires intensive temporary inpatient treatment, and then gets better. Although people with mental illness can learn coping skills, when they are experiencing a serious relapse they may not be able to make use of the skills they have learned, and they need to be hospitalized temporarily while medications and other forms of treatment are adjusted so they can return to healthy functioning.

Institutions for people with developmental disabilities like Broome Developmental Center are obsolete. State-of-the art practitioners learned long ago that people with developmental disabilities, including the most serious physical, intellectual, and behavioral disabilities, can permanently improve their skills, and function safely in integrated community settings, with appropriate support services. These integrated supports and settings can fully and safely substitute for segregated institutions for all but a handful of people.

The NY State Office of People with Developmental Disabilities (OPWDD) plans to keep two such facilities, totalling 300 beds, in operation for the tiny minority of people with developmental disabilities who exhibit highly persistent destructive or criminal behavior.

However, temporary intensive inpatient services for people with mental illnesses will always be necessary, in every community, because when people with these disabilities relapse, there is no substitute for immediate, intensive attention.

In any case, the proposal to close GBHC was not approved; it has been off the table since December 2013, when Governor Cuomo reached an agreement with local state legislators to slightly reduce the number of beds at the facility in exchange for an increase in community-based residential and support services.

No service system is perfect. People do fall through the cracks in any service system. However, it is extremely rare for a person to be moved out of an institution for people with developmental disabilities like BDC without receiving a wealth of appropriate residential and other support services. In most cases they are moved to group homes. In all but a tiny handful of cases, they receive effective coordination of services from people who pay close attention to them and the details of their needs.

The Broome County Department of Social Services (DSS), cited in the editorial, has taken a highly self-serving position on these issues. They mention three cases where a transition from institution to community for people with developmental disabilities failed. DSS has no legal responsibility for, or significant involvement in, services for people with developmental disabilities. On the other hand, DSS has primary local responsibility for services for people with mental illness. At any given moment, we can easily find hundreds of people with mental illness in Broome County who are homeless or in the county jail, due to the systemic inadequacies of the county’s mental health services.

This letter is already quite long and it has done no more than touch the surface of these very complex and serious issues. You certainly can print it if you like. However, we would like to invite the editors of the Pipe Dream to work with us to understand the issues in depth. Perhaps then you might do some investigative reporting and publish accurate articles on these issues, or encourage Binghamton University students to get more involved in promoting the civil rights of people with disabilities, and better services for them.

Thank you for your time and attention.

Ken Dibble

Policy Analyst

Southern Tier Independence Center, Inc.

(607) 724-2111 (voice/TTY)