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Inside Minnesota Prescription Drug Program — p. 8
Volume 11, Number 12
LRT Accessibility Update — Page 7
SOURCES
December 10, 2000
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“Never give up and sit down and grieve. Find another way..” — Satchel Paige
RESOURCES
December 10, 2000
Discrimination Charges Filed Complaint Issued Against Anoka Hospital by Nathan Halvorson
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hough Minnesotans rallied last month at the state capitol, honoring the completed transfer of people with developmental disabilities (DDs) out of state institutions and into the community, they may have celebrated too soon. The transfer is still incomplete. Five people with DDs currently live in Minnesota institutions—four at the Anoka Metro Regional Treatment Center (AMRTC) and one at Ah-Gwah-Ching, a nursing home for people with mental illness.
Pete Feigal
These five people are the subject of an official complaint written by the State of Minnesota Office of the Ombudsman for Mental Health and Mental Illness. On October 31, 2000, the Ombudsman’s office wrote
Pete Feigal: Advocate For Change by Amy Farrar
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epression and other “mental illnesses” are physically real and can disable a person on a multitude of levels, negatively affecting their physical, mental, psychological, and spiritual lives. This is the message nationally known advocate, speaker, educator, writer, and awardwinner Pete Feigal is successfully spreading throughout the country.
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Feigal knows his material very well. He has struggled with major depression on and off for 30 years. Feigal was also diagnosed with Multiple Sclerosis (MS) 13 years ago. Neither of these disabilities has prevented Feigal from seeing an opportunity every time a door shut in his face. Words can’t really define what Feigal has accomplished, but his story is one of hope, wonder,
and encouragement. “All of us have been wounded in some way,” said Feigal. “It’s the insights that come from this that makes us who we really are.” Who exactly is Pete Feigal? If he were to be described in a few words, those words would be creative, courageous, inspiring, and downright gutsy. Feigal was ten years old when he was first hit with depression. He said all he remembers of that time was feeling a pain and loneliness inside unlike any other kind of pain he had ever experienced. Feigal was officially diagnosed at 13 and institutionalized at the age of 15. This was in the late sixties, when information available to patients and their families on how to cope with depression was scarce, and the medical
community was just beginning to understand the illness. Sometimes depression is situational, other times it is not. Feigal emphasizes that it is a physical, biochemical disease. Feigal didn’t get the right kind of medical help until he was in his mid-twenties. For him, the right kind of help included medications to stabilize the neurotransmitters in his brain, but also cognitive therapy, which teaches patients to cut out the major sources of stress that can trigger their illness. The third element of Feigal’s recovery was his spirituality. He said patients with depression “need to focus not on their wounds, but on what they love. They need a reason to get out of bed.” Feigal - cont. on p. 9
the Office of Civil Rights (OCR) that “these individuals are being discriminated against on the basis of their developmental disability, a violation of their rights under the Americans with Disabilities Act (ADA) …to live in the most appropriate, integrated setting.” The Ombudsman’s office also alleges that the AMRTC case violates provisions of the 1999 Supreme Court Olmstead Decision, which basically prohibits confinement of individuals solely on the basis of insufficient resources in the community. Olmstead requires states to make all reasonable modifications to avoid “discrimination on the basis of disability.” At the same time, the Decision does not mandate that states make changes which would drastically alter the fundamentals of their governing systems. In the official notice, Roberta Opheim, Ombudsman, and Arlene Wegener, Client Advocate for the Ombudsman, raise several concerns regarding the continued residence of people with DD in state institutions. First, the support groups and programs available at the institutions focus primarily on people with mental illness (MI). Opheim insists that people with both a MI and DD do not benefit from these programs—developed for people who have a higher cognitive ability than those with mental retardation. Wegener adds that most of the programs at AMRTC are largely “selfdirected” and depend on the patient’s initiative. Secondly, Wegener indicates that the people sent to AMRTC for mental illness are usually referred there because they “had displayed aggressive or destructive behavior in the community.” The five people with DDs still in the
institutions, she feels, are more vulnerable to harm by such behavior due to their cognitive abilities. Another matter Opheim addresses relates to the length of stay at AMRTC. According to her, these are five “real people coming up on a year where after a month they’re stabilized and ready to go and now they can’t go. And to sit there for a year in an institution that you do not need to be in constricts their rights.” The Ombudsman office maintains that their complaint is not specifically directed at AMRTC or DHS (the organization that operates both AMRTC and Ah-GwahChing, and the organization that distributes Medicaid funding). Instead, they say it is a multi-system problem. Hospitals cannot afford to keep patients in their wings for the extended time it takes for a person’s MI to stabilize, so county courts refer these people to treatment centers such as Anoka. The courts commit people to AMRTC because they are unable to find a more appropriate place for them in the community. Law requires that Anoka accept all patients sent to them through the courts. Then, leaders of the county say they cannot return patients back into community living because, again, the appropriate place does not exist for these individuals. Plus, Opheim notes, the State is obligated to ensure that counties develop services in the community and that county social workers, family members and others who would assist in a person’s independent living are aware of such services. The solution and the aim of the OCR complaint, she says, is “to push all these systems to come together and ask ‘What do we have to develop to make this
happen?’” Elaine Timmer, Assistant Commissioner of State-Operated Services for DHS, stands by DHS and its actions to capably and appropriately manage these people with both MI and DDs at the treatment centers. She responds to the Ombudsman complaint by defending the system’s efforts in treatment at Anoka and the measures taken to return these people to the community. “The treatment that they receive (at AMRTC) is active treatment for their mental illness. There’s a variety of treatment approaches such as psychiatric evaluations, medication, and assessments that are individualized for every single patient referred to the facility.” Regarding Ombudsman concerns that the five patients were admitted as having mental illness when, in truth, they did not, and that treatment at the institutions is inappropriate for their cognitive abilities, she answers “These patients were appropriately referred to AMRTC by the courts. They receive appropriate treatment there, and plans are underway to give them an appropriate discharge.” She continues, noting AMRTC’s committment to returning these people placed in the community: “We actually begin planning for (an AMRTC patient’s) discharge on the first day they arrive at the facility. We work with the county, family members and others to plan for that discharge.” Timmer explains that the needs of these few people prevent them from a timely return to the community. She comments “the effort it takes in order to find…placement back in the
Anoka - cont. on p. 5
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