Meyer (1980) found that over 70% of families were satisfied with an institution in Pennsylvania, and were against the idea of community placement. More recently, the instrument was adapted for wide use in conjunction with the Individualized Data Base at UCLA. The analyses of interest concerned only those who were aware of the existence of the CLA. In R. Bruininks and C. Lakin (Eds. Normally, specialization is expected to enhance efficiency and productivity, but, in this kind of human service organization, the opposite may be true. Washes and dries self with help3. No Answer, 14. EXHIBIT 8-2. Some counties only include those individuals whose need for residential services constitutes an "emergency," whereas other counties include individuals whose need is likely to occur in the future. WebPennHurst, the legendary haunted hospital complex has opened its doors after 25 years and is accepting new patients! New facilities, however, would be limited to under 16 beds and no new construction was allowed. Six months after opening, we asked the people who were aware of the CLA how they had felt when they had first heard about it, as well as how they felt about it at the time of the interview. In fact, that is the direction this research team would recommend for the future. Such a policy should apply across agencies and departments and should influence system design issues in income maintenance, housing construction and rent subsidy, medical services, long-term care, and social services. However, the biggest growth is in the area of professional services (over 100% increase in the last few years) and also in transportation, utilities and communications (70% to 75% increase). Include any change of address. As a comparison, and to avoid sensitizing respondents, respondents were also asked how much they would be bothered if members of other groups moved into the neighborhood. 12. Improve self concept, self esteem GOALS CONCERNING WORKING 60. (PROBE FOR MONTH AND YEAR) MONTH _______ YEAR _______ 14. None1. But, I look on it as a challenge in this country to change the system that applies to human beings. When Judge Broderick ordered community placement for all Pennhurst residents on March 17, 1978, there were 1,154 persons at the facility. Further, the use of litigation to bring about reforms in social institutions was still somewhat new and was limited primarily to racial discrimination and reapportionment. In the Pennhurst case, this definitely did happen. Per Diems in State Centers for the Mentally Retarded: 1977-1978 and 1983-1984 in FY 78 Dollars SOURCE: Office of Mental Retardation, Department of Public Welfare, Harrisburg, PA. That contract, which at the time was for approximately $1,000,000, greatly improved medical care at the facility and contributed to an escalating per them rate. No Answer 2. The data on individual growth, services, environmental qualities, family reactions, and public costs combine to suggest that, if ease of access and reimbursement rates were equal, state officials would quickly see the payoffs of shifting to community-based service systems. (CHECK UP TO THREE) _______ Academic (basic reading, writing and use of numbers) 6.8% _______ Behavioral (therapy, behavior modification, eliminating program behaviors) 48.3% _______ Medical (check-ups, surgery, physical therapy, dental, nursing) 72.0% _______ Recreation (trips, hobbies, sports, arts, crafts) 30.9% _______ Self-care (grooming, hygiene, dressing, nutrition) 65.7% _______ Speech (evaluation, therapy, training) 30.5% _______ Work and work-training (preparation and training for work) 15.6% _______ Other ( DESCRIBE ): _________________________ 8.3% 43. We suggest that, at least in Pennsylvania, the issue of residential settings has been resolved in favor of the community, but that day services should be the next target for capacity building through technical assistance and innovative demonstration programs. One-fourth of the non-respondents were telephoned and asked a subset of the survey questions; it was determined that the 472 respondents were representative of the population of 630. According to those interviewed at Pennhurst, some of these individuals are reluctant to leave Pennhurst since they consider Pennhurst their home. This new approach, if combined with emphasis on the constitutional rights to freedom from harm and nondiscriminatory habilitation, makes possible a direct attack on the very concept of institutionalization as a method of providing services to retarded people. No difficulty in seeing3. Assuming that the utilization of physician services by Pennhurst class members residing in the community was not appreciably different than the utilization of physician services by other severely disabled Medicaid recipients in fiscal year 198182, the physician utilization rate and related charges in the community were far less per client than at the Pennhurst Center. CLA personnel are knowledgeable and skillful 3.5 1.9 18. Though the General Accounting Office made a similarly strong recommendation in 1977, the results of the Pennhurst study suggest that, though some steps have been taken in the interim, federal policies still remain contradictory and place severe constraints on those states attempting to develop more responsive and cost effective community-based systems of care. Please include any pensions, retirement plans, etc. Evidence and expert testimony had convinced the judge that people would be better off out of Pennhurst Center but no one was really certain. In this discussion, we will comment on both. However, it should be kept in mind that 80% of those placed out so far have severe and profound disabilities. _______ 1. In states where community programs are funded primarily with state dollars, deinstitutionalization will result in a direct loss of federal funding and a concomitant drain on scarce state funds. 11. Since the Longitudinal Study began, key informants interviewed both at the local and state level have maintained that the cost of community care for class members is substantially inflated over the cost of caring for non-class members. If you could, would you like to leave here and live somewhere else ? These attitudes change when the existing attitude is insufficient for dealing with situations, whether because of new information or because of a new environment of some kind. This page was last edited on 12 April 2021, at 11:14. For both groups, then, we would infer that they are better off in terms of the risk of overuse of medications. Our repeated offer to provide the data tape for ACMRDD to conduct its own search for a relationship between growth and the ACMRDD characteristics of the living area received no response. Makes no attempt to wash or dry self CARE OF CLOTHING (Check all statements that apply ) _______ a. Cleans shoes when needed_______ b. _________________________. Does not clear table at all, 3. Adaptive Behavior Growth: 5 Observations, 92 People, EXHIBIT 4-10. To those families who institutionalized their children, deinstitutionalization represents a "painful revisitation" of the original decision (Willer et al., 1979). the level of sophistication and development of the existing state mental retardation system; the extent of public pressure for reform; the explicit or implicit agenda of state officials; the nature of the relationship between state program officials and the state's attorney general; the orientation of the state's political leadership; the extent of previous litigation in the state; the judicial strategies employed by the federal judge in contested and uncontested cases; the nature of the decree and the monitoring mechanism established; the strategies employed by the plaintiffs; the level and distribution of state resources.
The Least Restrictive Alternative says that mentally retarded persons should be allowed to live in places which are as much like normal homes as possible. The analysis was based on key informant interviews in Pennsylvania, Maine and Michigan as well as on a review of the legal literature and the literature on legal theory. PRICE TOTAL Name______________________________________ _________ _________ ______ ______ Organization_________________________________ _________ _________ ______ ______ Address____________________________________ _________ _________ ______ ______ ___________________________________________ _________ _________ ______ ______ City________________________ State___________ _________ _________ ______ ______ Zip Code___________________ _________ _________ ______ ______ _________ _________ ______ ______ TOTAL ENCLOSED = $_____________ HUMAN SERVICES RESEARCH INSTITUTE CODE NO. This implies that institutional environments and small community environments are so different that it may be an error to try to use the same set of of standards for both. Don't Know9. Of the initial cohort at Pennhurst, 4% were mildly retarded, 10% moderately retarded, 30% severely retarded, and 56% profoundly retarded. Develop hobby(s) -- arts, crafts, music, leisure reading, games, collecting, etc.82. About once a week or more How often did the Friend-Advocate make contact by phone or visit (in past year)? The administration at Pennhurst is somewhat sensitive about plaintiff concerns regarding monitoring during the phase down of the facility. Another source of information about provider capacity comes from the key informant interviews. In addition to problems in the delivery of services, the Committee also appears to have been strongly influenced by the Pennhurst litigation. (RECORD AS MANY AS APPLY) # of Relatives a. on a daily basis? The sources of broader policies that affected the system were the Governor, the Department of Public Welfare and the legislature.
The validity of that assumption merits further investigation before drawing final conclusions about the nature of quality in services for people with mental retardation. Most of the industry in the county is concentrated along the Schuylkill River, the Pennsylvania Turnpike, and the North Penn area. Behavior Modification -- To reduce maladaptive behavior.
Moreover, one must be open to the possibility that the amount of time spent by staff in service to clients may be more a function of dynamic factors such as program leadership, staff training, and the proclivities of individual staff than a function of either the types of clients served or the organizational structure. Some respondents felt it was "not safe" and "rather dangerous" for "these people" to "walk around alone." Your own social life b. Level of funding may, however, bear on the decree of progress a state is able to make in implementing the decree. Puts clothes in drawer or chest neatly_______ c. Puts soiled clothes in proper place for laundering/washing without being reminded_______ d. Hands up clothes without being reminded_______ NONE OF THE ABOVE DRESSING _______ 6. Toileting03. Survey sampling. Each Overview report corresponded to a specific time period during which certain key events concerning the decree transpired. In contrast, funding for CLAs has come primarily from states and/or short-term federal demonstrations. (Record responses verbatim) Leave box blank _______ STAFF How many full time staff work at this living area or residents -- DIRECT CARE ONLY, NOT INCLUDING THERAPISTS AND OTHER PROFESSIONALS? There has been no decrease in any area of satisfaction or happiness.
In the two comparison states, state lawyers were more influenced by the agenda of state mental retardation program officials than was the case in Pennsylvania. _______ In an average week, how many hours are worked by these full time staff? 5 4 3 2 1 9 c. Severely retarded people should not marry. To summarize, the further the lawsuit ranges from the concept of a specific wrong and a specific malefactor, the more difficult it is to design remedies that encompass the full range of actions and actors needed to secure system reform.
APPENDIX 8-1: NEIGHBOR ATTITUDES QUESTIONNAIRE 1 INSTITUTE FOR SUREVEY RESEARCHTEMPLE UNIVERSITY--Of The Commonwealth System Of Higher Education--1601 NORTH BROAD STREETPHILADELPHIA, PENNSYLVANIA 19122 STUDY #540-350-02OMB No.
The respondents said they would be bothered very little by new neighbors with physical disabilities, or with mild mental retardation, or of a different race. No difficulty in hearing3. Placement of the mentally retarded relative into an institution outside the home. As previously noted, we had composed such a scale by combining 13 items (ATTSCALE). At the Pennhurst Center, physicians engage in a number of prevention activities, prescribe and oversee the nurses' administration of client medications, and treat general client illnesses both on the wards and in the infirmary. Jones, P., Conroy, J., Feinstein, C., and Lemanowicz, J. (Have you always lived here?) (1969). There are many ways of assessing what happened to class members. Altogether, these three variables explained 12.2% of the variation in our measure of attitudes toward people with mental retardation. Family attitudes toward deinstitutionalization. The Southeast Region includes a total of 42 community living arrangement providers authorized to serve 820 mentally retarded individuals in small group residences. The medical model versus development model of care -- Simply put, the medical model tends to view the relationship between staff and residents in terms of doctor and patient and emphasizes diagnoses and prognoses, and treatment services. This concept is one of the cornerstones of the new ideology in mental retardation services. Patterns of residential care: Sociological studies in institutions for handicapped children. Gilhool, T. A Commentary on the Pennsylvania Right to Education Suit. In addition, there are 134 private and parochial schools located in the area. In addition, there were many expressions of concern about the security of funding for the CLAs from both the respondents who approved the move and those who did not. ), Litigation and the Mentally Disabled. The focus of the Pennhurst Longitudinal Study was to test whether attitudes of Pennhurst families fit this pattern, and then to take the unprecedented next step: test for changes among the same families after community placement of their relatives. The cost finding procedure was designed to capture as fully as possible the resources expended directly and indirectly, in the course of delivering services to clients. Per Capita Allocation of State Funds for Community Services by Region SOURCE: Office of Mental Retardation, Department of Public Welfare, Harrisburg, PA. Another way of viewing the same phenomenon is to chart the growth in the amount of money allocated per mentally retarded person served in each region. Although cautions against perfectly confident generalization to the population, or to facilities in other states, must be applied to the Pennhurst results, we believe that some general policy implications can be drawn. Frohboese, R., &.
Our questionnaire contained one pair of questions to check recency: Q8: Are you usually happy or sad? Minneapolis: University of Minnesota, Developmental Disabilities Project on Residential Services and Community Adjustment, Project Report #15. _______ 0. While confined at Pennhurst, Romeo was injured on over 70 occasions either by injuries that were self-inflicted or the result of attack by other residents. 15. Individual Behavioral Development. One possible scenario -- one that Sigelman (1976) has found -- is that even a small number of community members who are strongly opposed can influence general community sentiment, to the extent that the CLA does not open. Joan has Down's Syndrome and is legally blind. CLA or group home (Yes)8. To date, no one federal program is directly relevant to deinstitutionalization, yet many have some bearing on mentally disabled persons living in the community or in institutions. Drinks without spilling, holding glass in one hand3. 11). In the Southeast Region, the land is fertile and well-farmed. The court ordered that special preference for early placement be given to children. A Couple (1 or 2) 5. Regional HCFA staff stated that the proposal lacked detail and cited numerous issues that had to be resolved.
9.2% 11.7% 22.8% 19.8% 36.6% 19. Some states, even after consent agreements were signed, resisted the court's jurisdiction. If one is already in the neighborhood, then opposition will be even less, and strong support may be available. Don't Know9. The evaluation concluded that, due to the atrophy of Joan's eyes and the muscles surrounding them, her upper and lower eyelids had grown inward, causing her irritation and pain. It shows an area with significant higher education and other training resources. In response to the Judge's order, the Commonwealth submitted a plan for placements over the next year and a half. Reduction of physical violence towards others31. Even our normalization measure, which definitely should be independent of individual functional level, was not. It is bounded on the north by Montgomery County; on the east by Philadelphia; on the south by the Delaware River and the State of Delaware; and on the west by Chester County. For both groups, then, we would infer that they are better off in terms of the risk of overuse of medications. Our study of the feelings of families in the deinstitutionalization process leads us to recommend that any good community or institutional service system should provide a clear and meaningful role for the families of people (particularly adults) with mental retardation. In the remaining program areas (case management, medical, and transportation), the cost finding procedures were not exact enough nor the number of programs large enough to yield definitive findings. Specialized workers often demand less pay than workers who are more broadly skilled, and their rate of production can markedly increase as they become proficient in their area of specialization. Have class members placed out of Pennhurst as a result of the decree fared better in small group settings than they fared at the institution? The initial theory was that since the institution was to be closed in a relatively short period of time, the development of more elaborate improvements would not be necessary. What Has Happened at Pennhurst? This was not significantly different from the baseline recency rate. The Characteristics of the Physical Environment was replaced by the Physical Quality Instrument (PQI) (taken from a modification of the MEAP Rating Scale created by Seltzer, 1982, and further modified by our group). Our results suggest, to us, that future research should include further examination of the effects of structured contact with the CLA residents after the CLA has opened. Residential programs were narrowly defined to include services provided by residential care staff (including nurses) and their immediate supervisors.
The retarded and institutions for the retarded -- A preliminary research report. 5) _______ 1. Industry in the county is relatively diverse. I wa nt to ask you some questions about your life and what you do every day. Subjects The sample of people interviewed in this part of the Pennhurst Study was not representative of the 1154 people who lived at Pennhurst in 1978, nor was it representative of all the people who moved to CLAs. In thinking about what your relative will need in the future, how much do you agree with this? Pennhurst was one of nearly 300 U.S. institutions that served half a million inmates during the 20th century. Rate of Change in Residential Census in State Centers and Mental Retardation Units Facility 1977/78 1983/84 % Change SOURCE: Office of Mental Retardation, Department of Public Welfare, Harrisburg, PA. * These people were integrated into the general population at the Philadelphia State Hospital or other State Hospitals.
While many families of people in institutions see group homes or community living arrangements (CLAs) as a viable way to care for some people, most prefer the institution for their own relatives (Atthowe & Vitello, 1982; Frohboese & Sales, 1980; Payne, 1976). (1983). Your job 3.5 2.9 d. Family recreation activities 3.4 2.8 e. Your time alone 3.5 3.0 f. Your time with your spouse 3.4 2.9 h. Family vacation 3.5 2.9 i. When a medical (e.g., seizure) or behavioral (e.g., tantrum) crisis specific to your relative was identified. The systems that do exist are old in design, often borrowed from mental health or medical applications, and do not contain the kinds of data that would be most useful for planning and evaluating community systems. Unchangeable factors. Exceptional Children, 46, 459-461. 4 3 2 1 c. Who are severely mentally retarded? That contract, which at the time was for approximately $1,000,000, greatly improved medical care at the facility and contributed to an escalating per them rate. Their article, titled "When in doubt, say Yes," concluded that many people with retardation were likely to say "Yes" to any question that was not clear, concrete, and immediate. _______ Medicaid (M.A.)
The Least Restrictive Alternative says that mentally retarded persons should be allowed to live in places which are as much like normal homes as possible. The analysis was based on key informant interviews in Pennsylvania, Maine and Michigan as well as on a review of the legal literature and the literature on legal theory. PRICE TOTAL Name______________________________________ _________ _________ ______ ______ Organization_________________________________ _________ _________ ______ ______ Address____________________________________ _________ _________ ______ ______ ___________________________________________ _________ _________ ______ ______ City________________________ State___________ _________ _________ ______ ______ Zip Code___________________ _________ _________ ______ ______ _________ _________ ______ ______ TOTAL ENCLOSED = $_____________ HUMAN SERVICES RESEARCH INSTITUTE CODE NO. This implies that institutional environments and small community environments are so different that it may be an error to try to use the same set of of standards for both. Don't Know9. Of the initial cohort at Pennhurst, 4% were mildly retarded, 10% moderately retarded, 30% severely retarded, and 56% profoundly retarded. Develop hobby(s) -- arts, crafts, music, leisure reading, games, collecting, etc.82. About once a week or more How often did the Friend-Advocate make contact by phone or visit (in past year)? The administration at Pennhurst is somewhat sensitive about plaintiff concerns regarding monitoring during the phase down of the facility. Another source of information about provider capacity comes from the key informant interviews. In addition to problems in the delivery of services, the Committee also appears to have been strongly influenced by the Pennhurst litigation. (RECORD AS MANY AS APPLY) # of Relatives a. on a daily basis? The sources of broader policies that affected the system were the Governor, the Department of Public Welfare and the legislature.
The validity of that assumption merits further investigation before drawing final conclusions about the nature of quality in services for people with mental retardation. Most of the industry in the county is concentrated along the Schuylkill River, the Pennsylvania Turnpike, and the North Penn area. Behavior Modification -- To reduce maladaptive behavior.
Moreover, one must be open to the possibility that the amount of time spent by staff in service to clients may be more a function of dynamic factors such as program leadership, staff training, and the proclivities of individual staff than a function of either the types of clients served or the organizational structure. Some respondents felt it was "not safe" and "rather dangerous" for "these people" to "walk around alone." Your own social life b. Level of funding may, however, bear on the decree of progress a state is able to make in implementing the decree. Puts clothes in drawer or chest neatly_______ c. Puts soiled clothes in proper place for laundering/washing without being reminded_______ d. Hands up clothes without being reminded_______ NONE OF THE ABOVE DRESSING _______ 6. Toileting03. Survey sampling. Each Overview report corresponded to a specific time period during which certain key events concerning the decree transpired. In contrast, funding for CLAs has come primarily from states and/or short-term federal demonstrations. (Record responses verbatim) Leave box blank _______ STAFF How many full time staff work at this living area or residents -- DIRECT CARE ONLY, NOT INCLUDING THERAPISTS AND OTHER PROFESSIONALS? There has been no decrease in any area of satisfaction or happiness.
In the two comparison states, state lawyers were more influenced by the agenda of state mental retardation program officials than was the case in Pennsylvania. _______ In an average week, how many hours are worked by these full time staff? 5 4 3 2 1 9 c. Severely retarded people should not marry. To summarize, the further the lawsuit ranges from the concept of a specific wrong and a specific malefactor, the more difficult it is to design remedies that encompass the full range of actions and actors needed to secure system reform.
APPENDIX 8-1: NEIGHBOR ATTITUDES QUESTIONNAIRE 1 INSTITUTE FOR SUREVEY RESEARCHTEMPLE UNIVERSITY--Of The Commonwealth System Of Higher Education--1601 NORTH BROAD STREETPHILADELPHIA, PENNSYLVANIA 19122 STUDY #540-350-02OMB No.
The respondents said they would be bothered very little by new neighbors with physical disabilities, or with mild mental retardation, or of a different race. No difficulty in hearing3. Placement of the mentally retarded relative into an institution outside the home. As previously noted, we had composed such a scale by combining 13 items (ATTSCALE). At the Pennhurst Center, physicians engage in a number of prevention activities, prescribe and oversee the nurses' administration of client medications, and treat general client illnesses both on the wards and in the infirmary. Jones, P., Conroy, J., Feinstein, C., and Lemanowicz, J. (Have you always lived here?) (1969). There are many ways of assessing what happened to class members. Altogether, these three variables explained 12.2% of the variation in our measure of attitudes toward people with mental retardation. Family attitudes toward deinstitutionalization. The Southeast Region includes a total of 42 community living arrangement providers authorized to serve 820 mentally retarded individuals in small group residences. The medical model versus development model of care -- Simply put, the medical model tends to view the relationship between staff and residents in terms of doctor and patient and emphasizes diagnoses and prognoses, and treatment services. This concept is one of the cornerstones of the new ideology in mental retardation services. Patterns of residential care: Sociological studies in institutions for handicapped children. Gilhool, T. A Commentary on the Pennsylvania Right to Education Suit. In addition, there are 134 private and parochial schools located in the area. In addition, there were many expressions of concern about the security of funding for the CLAs from both the respondents who approved the move and those who did not. ), Litigation and the Mentally Disabled. The focus of the Pennhurst Longitudinal Study was to test whether attitudes of Pennhurst families fit this pattern, and then to take the unprecedented next step: test for changes among the same families after community placement of their relatives. The cost finding procedure was designed to capture as fully as possible the resources expended directly and indirectly, in the course of delivering services to clients. Per Capita Allocation of State Funds for Community Services by Region SOURCE: Office of Mental Retardation, Department of Public Welfare, Harrisburg, PA. Another way of viewing the same phenomenon is to chart the growth in the amount of money allocated per mentally retarded person served in each region. Although cautions against perfectly confident generalization to the population, or to facilities in other states, must be applied to the Pennhurst results, we believe that some general policy implications can be drawn. Frohboese, R., &.
Our questionnaire contained one pair of questions to check recency: Q8: Are you usually happy or sad? Minneapolis: University of Minnesota, Developmental Disabilities Project on Residential Services and Community Adjustment, Project Report #15. _______ 0. While confined at Pennhurst, Romeo was injured on over 70 occasions either by injuries that were self-inflicted or the result of attack by other residents. 15. Individual Behavioral Development. One possible scenario -- one that Sigelman (1976) has found -- is that even a small number of community members who are strongly opposed can influence general community sentiment, to the extent that the CLA does not open. Joan has Down's Syndrome and is legally blind. CLA or group home (Yes)8. To date, no one federal program is directly relevant to deinstitutionalization, yet many have some bearing on mentally disabled persons living in the community or in institutions. Drinks without spilling, holding glass in one hand3. 11). In the Southeast Region, the land is fertile and well-farmed. The court ordered that special preference for early placement be given to children. A Couple (1 or 2) 5. Regional HCFA staff stated that the proposal lacked detail and cited numerous issues that had to be resolved.
9.2% 11.7% 22.8% 19.8% 36.6% 19. Some states, even after consent agreements were signed, resisted the court's jurisdiction. If one is already in the neighborhood, then opposition will be even less, and strong support may be available. Don't Know9. The evaluation concluded that, due to the atrophy of Joan's eyes and the muscles surrounding them, her upper and lower eyelids had grown inward, causing her irritation and pain. It shows an area with significant higher education and other training resources. In response to the Judge's order, the Commonwealth submitted a plan for placements over the next year and a half. Reduction of physical violence towards others31. Even our normalization measure, which definitely should be independent of individual functional level, was not. It is bounded on the north by Montgomery County; on the east by Philadelphia; on the south by the Delaware River and the State of Delaware; and on the west by Chester County. For both groups, then, we would infer that they are better off in terms of the risk of overuse of medications. Our study of the feelings of families in the deinstitutionalization process leads us to recommend that any good community or institutional service system should provide a clear and meaningful role for the families of people (particularly adults) with mental retardation. In the remaining program areas (case management, medical, and transportation), the cost finding procedures were not exact enough nor the number of programs large enough to yield definitive findings. Specialized workers often demand less pay than workers who are more broadly skilled, and their rate of production can markedly increase as they become proficient in their area of specialization. Have class members placed out of Pennhurst as a result of the decree fared better in small group settings than they fared at the institution? The initial theory was that since the institution was to be closed in a relatively short period of time, the development of more elaborate improvements would not be necessary. What Has Happened at Pennhurst? This was not significantly different from the baseline recency rate. The Characteristics of the Physical Environment was replaced by the Physical Quality Instrument (PQI) (taken from a modification of the MEAP Rating Scale created by Seltzer, 1982, and further modified by our group). Our results suggest, to us, that future research should include further examination of the effects of structured contact with the CLA residents after the CLA has opened. Residential programs were narrowly defined to include services provided by residential care staff (including nurses) and their immediate supervisors.
The retarded and institutions for the retarded -- A preliminary research report. 5) _______ 1. Industry in the county is relatively diverse. I wa nt to ask you some questions about your life and what you do every day. Subjects The sample of people interviewed in this part of the Pennhurst Study was not representative of the 1154 people who lived at Pennhurst in 1978, nor was it representative of all the people who moved to CLAs. In thinking about what your relative will need in the future, how much do you agree with this? Pennhurst was one of nearly 300 U.S. institutions that served half a million inmates during the 20th century. Rate of Change in Residential Census in State Centers and Mental Retardation Units Facility 1977/78 1983/84 % Change SOURCE: Office of Mental Retardation, Department of Public Welfare, Harrisburg, PA. * These people were integrated into the general population at the Philadelphia State Hospital or other State Hospitals.
While many families of people in institutions see group homes or community living arrangements (CLAs) as a viable way to care for some people, most prefer the institution for their own relatives (Atthowe & Vitello, 1982; Frohboese & Sales, 1980; Payne, 1976). (1983). Your job 3.5 2.9 d. Family recreation activities 3.4 2.8 e. Your time alone 3.5 3.0 f. Your time with your spouse 3.4 2.9 h. Family vacation 3.5 2.9 i. When a medical (e.g., seizure) or behavioral (e.g., tantrum) crisis specific to your relative was identified. The systems that do exist are old in design, often borrowed from mental health or medical applications, and do not contain the kinds of data that would be most useful for planning and evaluating community systems. Unchangeable factors. Exceptional Children, 46, 459-461. 4 3 2 1 c. Who are severely mentally retarded? That contract, which at the time was for approximately $1,000,000, greatly improved medical care at the facility and contributed to an escalating per them rate. Their article, titled "When in doubt, say Yes," concluded that many people with retardation were likely to say "Yes" to any question that was not clear, concrete, and immediate. _______ Medicaid (M.A.)