Is it time to close the door on Yakima Valley School?

YAKIMA, Wash. — Meet Michael Carpenter, a 41-year-old man who lives in an apartment with a caregiver in Ellensburg. He works, rides public transportation and is active in a disability-rights group.

From age 5 to 14, Carpenter lived at Yakima Valley School, a state-run facility for the developmentally disabled in Selah.

Said Carpenter: "The institution was not a good place for me to live. I wasn't able to go out and do things like I do now."

Now meet Don Senger, a 6-foot, 275-pound, 55-year-old man. He's paralyzed on his left side and makes sounds, not words. Sometimes when he's frustrated, he swings his strong right arm at the nearest person.

After Senger's father died, his mother, Irene, tried to take care of him by herself but she simply couldn't manage. For years, he was shuttled between nursing homes, group homes and a state mental hospital. Nobody could handle him. Nobody wanted him -- until his mother got him into Yakima Valley School nine years ago.

Said Senger: "He's doing great."

Senger and Carpenter represent two sides of a passionate debate that's emerged since Gov. Chris Gregoire recommended closing Yakima Valley School as part of her austere two-year budget.

To some, Yakima Valley School is a home where the most vulnerable people in society get loving and professional care from an experienced staff.

But to others, the school is an archaic -- and expensive -- institution where the disabled are hidden from the community, deprived of the chance to live more independently.

Those who philosophically oppose centralized residential care have seized Washington's budget crisis to advance their case for community living. And those who benefit from the existing system have mounted letter-writing campaigns and are planning a trip to Olympia on Monday to lobby legislators.

Meanwhile, the debate has parents like Irene Senger, 78, fearful about their children's' future.

"Where will he go? Will I be able to see him?" Senger asks.

The state Aging and Disabilities Services Administration, which oversees the school, would contract with private providers to move residents into group homes, apartments or skilled nursing homes by 2011. Residents may also be transferred to one of the four other residential schools operated by the state.

"We don't know exactly where people would go. Those discussions haven't occurred yet," said Kathy Leitch, assistant secretary of the Department of Social and Health Services.

Rep. Kelli Linville, a Bellingham Democrat who chairs the powerful House Ways and Means Committee, said the Health and Human Services Appropriations Committee, which makes funding recommendations to her committee, is examining the type of services Yakima Valley School provides and whether they can be delivered in the community. A recommendation should reach Linville's committee next month.

While it costs $17.7 million a year to operate the school, the state predicts it would save only $1.2 million a year if all the residents are moved to other settings and the school is closed. That's because the state would still be financially responsible for their care.

One of the most persistent questions is why the Selah school was selected for closure ahead of the other five state-run facilities. Gregoire's advisers say it's because the residents' conditions are among the least "acute" as measured by a scoring system for long-term, nursing-home care.

But school supporters say that score is artificially low because the scoring isn't designed to capture the acuity of residents admitted for respite care. Many of those who stay at the school for days or weeks at a time for respite care -- when families are given occasional breaks from caregiving -- are severely disabled or medically fragile.

The state Aging and Disabilities Services Administration stands by its assessment.

The school's size is also a factor, officials say. With 87 residents but a capacity of 112, Yakima Valley School is the second-smallest institution after the Frances Haddon Morgan Center, a newer facility in Bremerton that focuses on autism and is near capacity with 54 residents.

"Yakima Valley School is a small facility and you could generate a savings in the immediate biennium," said Linda Rolfe, director of the Division of Disabilities. "At a larger facility, it takes more than (two years) to close down."

Rep. Bruce Chandler, R-Granger, doesn't buy that argument. He points to a 2002 study by the Joint Legislative Audit and Review Committee that concluded Yakima Valley School was the second most efficient of the five schools, just behind Rainier School in Buckley.

The same study, however, also concluded that Yakima and Lakeland Village near Spokane were the most obsolete because of excess capacity.

Parents of residents don't believe any of the numbers. They smell politics.

For years, Alex Deccio, the veteran Republican state senator from Yakima, nearly single-handedly kept the school from the chopping block. He had help from former Reps. Jim Clements, R-Selah, and the late Mary Skinner, R-Yakima.

Their combined seniority and willingness to negotiate with Democrats bought the school relative security. The current 14th District delegation, which is relatively new to the Legislature, lacks that clout.

"With Deccio, Clements and Skinner gone, the state decided to pick on Yakima Valley School," said John Mahaney. When he needs a break from taking care of his son Mark at home in Yakima, Mahaney takes him to the school for a temporary stay.

Other factors have long been working against Yakima Valley School and the other state-run facilities in Buckley, Shoreline, Bremerton and Medical Lake near Spokane. Populations at all five have been declining for decades, reflecting a national trend toward community living that's been hastened by disabilities-rights legislation.

State disabilities administrators have embraced community living and, as a result, have denied many admissions to the facilities.

In 1967, more than 4,000 people lived in six state-run facilities. By 2008, there were 988 in five facilities. Interlake School in Medical Lake was closed in 1994.

The institutions have deliberately downsized over the years, reflecting the growing number of parents who choose to keep their children at home or in a community setting. Currently there are about 50 empty beds among all five residential facilities.

The state attempted to close Fircrest in Shoreline in 2003 and had the support of Sen. Darlene Fairley, a Democrat whose district includes the school. But political pressure by parents and the Washington State Federation of Labor kept Fircrest open, although several of its cottages have been shut down.

Yakima Valley School once had 250 beds but the number has been deliberately cut to its current capacity of 128. Of its 87 residents, at least half are from Western Washington. Sixteen beds are kept for respite care.

Behind the declining occupancy is cumulative and incontrovertible research that shows the health and behavior of people with physical, mental and emotional challenges improves when they live in smaller settings, close to family, friends and recreational opportunities.

Other states have been closing residential schools for the developmentally disabled, including Oregon, which has proposed phasing out its last standing facility, the Blue Mountain Recovery Center in Pendleton.

"This has been a major, major change across the nation," said Charlie Lakin, director of the Research and Training Center on Community Living at the University of Minnesota. "In that sense, Washington isn't doing anything differently. There is not a single state that hasn't reduced its state-operated population by something notable."

Leitch, DSHS's assistant secretary, said Washington has no plans to shut down every state-run facility.

"I haven't heard any governor say there is not going to be that option for parents," she said.

Integrating, or mainstreaming, the developmentally disabled into communities is hardly a radical notion pushed by academics. The Centers for Disease Control and Prevention embraced the concept in 2001 in its "Vision for a Decade" document.

"Institutions and other forms of congregate care are inconsistent with positive public health policy and practice. They diminish people's opportunities to realize the essential features of human well-being: choice, control, ability to establish and pursue personal goals, family and community interaction, privacy, freedom of association, and the respect of others."

A landmark U.S. Supreme Court case in 1999, called the Olmstead decision, affirmed the right of developmentally disabled individuals to live in the community. But the same decision recognized that community-based treatment shouldn't be forced on patients who don't want it.

"Persons with disabilities must be provided the option of declining to accept a particular accommodation," the court said.

Marian Endicott, a retired special education teacher, doesn't want to give up her choice to keep her son Clark, 32, at Yakima Valley School. She and her husband took care of him at home in Yakima until he was 28, when Endicott developed health problems.

"The law provides for a full range of care but the state is making us out to be bad parents if you put your child in an institution," she said.

Though critics say the premise of Yakima Valley School is obsolete, the facility is a far cry from the stereotyped images of dimly lit institutions with long, dark hallways and concrete floors.

The main building opened in 1947 as a tuberculosis hospital. In 1958, the hospital was converted to a residential facility for the developmentally disabled. And in the 1980s, residents moved from the main building into duplex cottages that house eight on each side.

Karen Vancamp worked in the old, three-story building when it housed residents.

"It was an institution then. We've come a long way," Vancamp said.

The original building continues to houses administrative services and clinical and therapeutic programs, but the residents' lives revolve around the cottages.

Outside, the cottages have front and back porches and sport colorful banners and pinwheels in garden space. Inside, the decor is homey with clocks and pictures on the walls. Residents lie in comfortable recliners in the community room. Each has a uniquely decorated bedroom.

"People have a misconception. They think this is the institution of the old days. But this is home," said Anne Kruger of Yakima. Her daughter Theresa, 35, has lived at the school since she was 8.

Theresa has cerebral palsy, a neurological disorder that has permanently affected her body movements and muscle coordination. Rhonda Gottschalk, Theresa's favorite caregiver, administers her medications and repositions her frequently to prevent bed sores and to reduce the threat of pneumonia. Her feeding tube must be checked regularly because she likes to pull it out.

Gottschalk talks to Theresa, knows how to make her smile and can tell when she's uncomfortable or in pain.

"Theresa likes to have somebody she knows or she gets stressed out," she says.

It takes two caregivers to bathe and move residents like Theresa. They use a special lift that cradles her to prevent slips and falls. She also receives occupational therapy twice a week. Nursing care is available around the clock, and a doctor and psychiatrist make regular visits.

Dentists from the University of Washington volunteer at the school on a regular basis because, according to parents, most dentists in town either don't take Medicare or don't want developmentally disabled people waiting in their lobbies.

Yakima Valley School consistently ranks high in Medicare quality surveys and has been free of citations by state inspectors five years in a row.

Quality care, however, is expensive. It costs $508 a day to care for a resident at Yakima Valley School, or $185,785 a year, according to DSHS.

The average cost at the other four state institutions is about $565 a day. The federal government matches roughly half the cost to the state.

In contrast, a community-living situation -- where two to six people live in a home or apartment -- runs from $250 to $265 a day, or $88,006 a year.

The state says it could serve three developmentally disabled people in the community for every one now living at the school.

Supporters of Yakima Valley School argue that it's not less expensive to put the developmentally disabled in community-living situations because cost data aren't comparable. The institutional day rate, for example, includes housing, food, medical, psychiatric and dental care. The community rate doesn't include reimbursement for all of those additional services.

But salaries explain much of the difference in cost, too.

Yakima Valley School employees are not only experienced, they are union members with health-care and retirement benefits. An experienced adult-training specialist makes from $33,468 to $43,572 a year, not including benefits.

A beginning attendant counselor -- a staff member who feeds, medicates, bathes and diapers residents on a daily basis -- earns from $26,544 to $34,260.

Caregivers for private companies earn $9.65, which works out to about $19,300 a year.

It's the discrepancy in pay that most worries parents because it explains high staff turnover in privately run group and nursing homes. Parents with disabled children living at home say they train a new caregiver at least every six months. The average tenure at Yakima Valley School is seven years.

Group homes also have the right to refuse to keep an individual, leaving parents without options.

Parents should be demanding better community-based services for their children and advocating better pay for the people who care for their children, said Von Elison, executive director of Central Washington Disabilities Resources in Ellensburg, which provides help for families and the disabled who want to live independently.

Elison is part of the Coalition to Consolidate DD Institutions, which includes Arc of Washington, a statewide disabilities advocacy group that supports the proposed shutdown of the Selah school. The coalition wants the state to shut down all the residential facilities.

For now, the fate of Yakima Valley School lies in the hands of lawmakers.

"We are facing a horrible, unprecedented budget problem. I couldn't tell you right now that the school can be saved," said Linville, the Bellingham Democrat.

Even if she could make that prediction, the reality is that the school has been faced with political pressure to close before and it likely will again, given the changing landscape of the disabilities community.

Advocates like Elison aren't going to give up the fight.

* Leah Beth Ward can be reached at 577-7626 or lward@yakima-herald.com.

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