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Politics : PRESIDENT GEORGE W. BUSH -- Ignore unavailable to you. Want to Upgrade?

To: American Spirit who wrote (51223)	10/24/2000 2:25:26 AM
From: KLP	Respond to of 769667

Wrong again, AS....and now, with the info below, YOU will know the answer... The first part is a definition of the problem, and the second is part of a paper that a patient with a problem, penned..... rwjf.org The chronic care delivery system is in a state of flux. Traditional definitions and boundaries of home and institutional care, and the personnel who deliver chronic care services in these various settings, are blurring. New mechanisms for the delivery of care are emerging. Among the trends that have developed in recent years: Deinstitutionalization National policy over the past three decades has sought to minimize the number of people who must rely on institutions for personal assistance. This policy, known as deinstitutionalization, has created several important ripple effects. For one, many deinstitutionalized people with mental illness have encountered a community-based care system lacking in funding and coordination. Another significant effect is a change in the population living in nursing homes. Nursing home residents used to comprise a broad range of persons in various stages of illness and disability. Today, nursing homes care primarily for the frailest people, particularly those with significant mental impairments, strokes, or Alzheimer's disease. People in nursing homes tend to have few financial resources and some have no one looking out for their interests. The vulnerability of the deinstitutionalized population has raised concerns about ensuring that their well-being is adequately protected. Home care and other community-based alternatives People with functional limitations who once might have gone to a nursing home now have alternatives, such as home care, assisted living, and adult day care. Perhaps the single most salient trend in chronic care is the rapid emergence of home health care as a multifaceted source of services, ranging from intravenous infusion of medications to physical therapy. Between 1979 and 1990, the number of home health agencies providing Medicare services doubled. Agencies that cater to private payers increased in number as well, primarily among for-profit and hospital-based home health agencies. Home care expenditures almost doubled between 1990 and 1993. The average home care visit in 1993 cost about $66. Yet the quality of home care services varies widely because the industry does not have consistent standards, accrediting or licensing requirements, and few formal credentials are required for home health aides. In sum, this state of flux represents both risks and opportunities: there is an opportunity for services to become more person-centered and responsive, and for inefficient bureaucracies to be replaced. At the same time, questions remain of how to effectively target and allocate services within limited budgets, and of how best to measure and monitor the quality of care delivered by a widening range of personnel in an expanding array of settings. ***************************************** This is a "snip" of the article referenced below.... mentalhealth.com Between 1972 and 1979, my quality of life in the community was poor. My lifestyle resembled that of the many psychiatric patients I see living in the community today. I slept until noon or later every day, then spent the rest of the day and night wandering the streets - drifting from coffee shop to coffee shop. In terms of meaningful activities and personal relationships, I had lived better when I was a patient (six months in 1968)** at the Lake Shore Psychiatric Hospital in Toronto. Deinstitutionalization is effective in lowering the quality of life for the seriously ill. While community programs benefit psychiatric patients who are highly motivated, an effective institution is more able to meet the needs of those who are seriously ill. Continued deinstitutionalization will do what it has been doing since the early 1970s, lowering the level of care and support that sufferers of severe mental and emotional illness need and deserve.,/b> I speak as someone who has no vested job interest in an institution. My concern is for the welfare and for the needs of others. I question the real costs of deinstitutionalization

To: American Spirit who wrote (51223)	10/24/2000 7:56:28 AM
From: Brumar89	Respond to of 769667

They may not have been called homeless, but I can remember working on farms in the late '60's with a lot of winos who were in fact homeless. And this was in a small town so homelessness is nothing new. The deinstitutionalization of mental patients produced a lot more homeless and that began before Reagan's administration . . . though he didn't do anything to reverse it.

To: American Spirit who wrote (51223)	10/24/2000 9:13:50 AM
From: Rambi	Read Replies (1) \| Respond to of 769667

NOt only were you unable or unwilling to provide a factual basis for your claims and ignored the honest efforts of those who did, you fell back on insults-- the mark of someone who has no real intellectual defense. Despite the fact that people posted articles regarding the history of deinstitutionalization, facts about the program itself, actual statistics that showed the average stay in a mental hospital decreased by half in the 70s and continued decreasing into the 80s, and my own posts about being part of the program that physically moved these people out of hospital and into the community in the 70s, you continue to blindly insist that Reagan caused the problem. Did you even bother to read the supporting material posted by KLP or the post by nihil regarding the decrease in the normal stay of patients in mental hospitals in the 70s and 80s? From 1972 to 1980, days of hospitalization in non-federal psychiatric hospitals per thousand population fell from 661 to to 295. It fell to to 201 in 1989 Not one of us tried to claim that Reagan "fixed" the problem--the ACLU made sure that no one could in many instances-- but the facts are there regarding the implementation of a program that was destined to fail long before he took office. This was my point, and it continues to be. It is not a defense of Reagan; it is an insistence that facts not be distorted out of ignorant partisanship. It's stunning to find a mind so closed that it will even deny history when it doesn't conform to its own cherished chosen beliefs. I now understand the meaning of exercise in futility.

To: American Spirit who wrote (51223)	10/24/2000 9:34:24 AM
From: TigerPaw	Respond to of 769667

many homeless before Reagan's 80's I remember some of that time. I got my first starter home in 1977 in an inexpensive neighborhood. We enclosed the garage in 1982. At that time a house down the block was being remodeled for what we later learned was a half-way house for patients getting out of the mental hospital. FYI - There were previously what were known as street people or rainbow people who drifted through town mostly following the Greatful Dead. These were a distinctively different group than those who graduated from the half way house. TP

To: American Spirit who wrote (51223)	10/24/2000 10:13:05 AM
From: Les H	Respond to of 769667

The severe recession of 1979-1981 with 12% unemployment may have had something to do with it. Most of the industries, agriculture, energy, mining, etc., that profitted from the inflation boom in the late 70s sufferred greatly in the 80s. Couple that with the inflationary housing boom then like the one we've been having. People without access to easy credit are going to be left out of the housing market.

To: American Spirit who wrote (51223)	10/24/2000 1:17:49 PM
From: KLP	Respond to of 769667

Surprised we haven't heard a response from you on this, AS...response book pages stuck together? You said: The word was created in the 80's. If you read any of the 5, now 6 responses to your post, and actually do some research, you will see the problem. And honestly, the free-wheeling drug use has helped increased the numbers of homeless people, some with mental problems caused from drugs... And as Rambi said, some has actually been caused by the ACLU. They have insisted that only by free will are people institutionalized...or restrained in wheelchairs, or beds, even if they fall and break bones (or worse)...They say people have to give their permission.....Nice thought, but sometimes people aren't able to help themselves that way.... The entire system needs to be revamped IMO...but NOT in a behind the closed doors wreck the system scenario as the Clintons' tried....we are in a far worse situation here than we were 8 years ago...again IMO....and I believe that the info out there would substantiate that...