Sacramento Bee

January 6, 1998

LETTERS:

Care for disabled

Re "Neglect of the disabled," editorial, Dec. 18: No one doubts that the Health Care Financing

Administration (HCFA) audit of California's Home and Community Based (HCB) Medicaid program

identified serious health and safety issues. However, The Bee's comparison of the movement of

people with developmental disabilities out of state institutions to the dumping of people with mental

illness is unfair and inaccurate.

The 35,000 individuals in the HCB program have disabilities severe enough to qualify for

institutionalization, but most have never been in a state hospital. Only about 2,500 individuals moved

out of state hospitals since the 1994 Coffelt vs. DDS lawsuit settlement agreement, and studies show

that most are living better lives.

The major issue is California's long history of inadequate funding, partly because of the state's dual

system of expensive state hospitals and community-based services. California spends almost as much

on the 4,000 individuals remaining in public institutions as it does on the 35,000 similarly disabled

people residing in community settings.

Also, California is the only state where all people with developmental disabilities are entitled to receive

services. Other states may spend more on community-based services for people with severe

disabilities, but they also have long waiting lists. In essence, California tries to serve all people with

developmental disabilities under an open-ended entitlement and closed-end budget.

--Bill Coffelt, President

The Oaks Group, Pollock Pines