In the August 14th Boston Sunday Globe there was a story about a shooting at a public housing complex in Brighton. According to the Globe article on Wednesday August 11th Randy Moore a 54 year old with a history of mental illness shot and killed his neighbor, William Thomas who was 75 years old and in a wheelchair. After a standoff for several hours, during which Moore shot multiple rounds at the police, Moore surrendered.
Bill McGonagle, head of the Boston Housing Authority, said that Moore was a diagnosed schizophrenic and lived in public housing for years. McGonagle also stated that Mr. Thomas's death underlines the risks of placing residents with serious mental illness alongside elderly residents. McGonagle went on to denounce the laws that put the mentally ill and elderly together in the same developments as poor public policy. According to the Globe article many other housing authorities across the state and country agree with McGonagle.
Massachusetts Department of Housing and Community Development, HUD, said in a statement that it had an "obligation" and "responsibility" to provide appropriate housing for those with disabilities. According to HUD there is a 70-30 ratio in effect for all 34 elderly housing developments run by Boston Housing Authority in order to meet the demand for non-elderly disabled housing in this area.
On April 15, 2011 the Centers for Medicare & Medicaid Services, CMS, proposed a rule which would effect the program: File Code, CMS-2296-P, Medicaid Program: Home and Community-Based Services (HCBS) Waivers, Federal Register, dated April15, 2011.
The proposed rule by CMS is designed to "remove a barrier for States that wish to design a waiver that meets the needs of more than one target population" by enabling States to combine target groups ( "Aged or disabled, or both; Mentally retarded or developmentally disabled, or both; and Mentally ill") into a single waiver.
What all this means is, individuals with different diagnosis can live "under one roof" with little or no regard to the individuals safety. As we read from the Globe article the mentally ill and elderly are not a good fit and now CMS wants to add individuals with developmental and intellectual disabilities to the mix. According to VOR, a National Advocacy Organization for individuals with DD/ID and with whom CCMR, Inc. is affiliated states that, "equal access" to necessary services does not equate to safety". "Tragedy due to placing incompatible people in the same homes has been reported in Florida, Maryland, Ohio, Washington DC, Wisconsin, Massachusetts, and other states".
As advocates for people with ID/DD we are concerned for the safety of everyone involved. There is a vast difference between people that are intellectually and developmentally disabled and those individuals with mental illness. Our biggest concern for the ID/DD population is their access to services. Mental health advocates also say that the issue is not housing but service to individuals with psychiatric disorders. In order for these individuals to live independently they need personal care. Lynda Cutrell of the National Alliance on Mental Illness states that "no matter what the housing situation, they need wraparound services to manage the illness".
The problem of mixed use housing is simple. All sides are right and all sides are wrong. There is not enough money to provide the needed and proper services on the ground and agencies like DDS and DMH are looking for additional ways to cut services. Federal agencies like CMS attempt to make policy changes based on "the perfect world" and not reality. Housing officials, the people who are actually working within these developments do not think that mixed use is a good policy and their position is based on experience.
Choice is important but safety for all is more important.
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