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Testimony re: HB 847, Health Care
Facilities - Recovery Housing Programs
As a social worker who has practiced in the State of Maryland for over 30 years
and as Vice-President of the Greater Washington Society of Clinical Social Work,
I come before this committee today as a representative of the Greater Washington
Society to lend my support for the enactment of HB 847. The majority of my
professional practice has involved helping persons with severe mental illnesses
and their families. As you all know, the locus of treatment has shifted from the
hospital to the community and thousands of Maryland citizens with severe
psychiatric disorders are now able to have productive lives in community
settings.
However, many of these persons need varying degrees of support in their homes in
order to support their recovery and community functioning. Thirty years ago, we
believed that the only way to accomplish this was to establish halfway houses
with 24 hour staffing. However, the cost of such facilities was prohibitive and
there were less than 100 beds in such homes across the State. Then I was
privileged to be part of an agency that “discovered” that most psychiatric
patients in need of such services could be well-served in ordinary shared
apartments with staff visiting for several hours perhaps two to four times per
week. The cost of these programs was barely one-tenth of the cost of a halfway
house bed.
Since then, we have learned that persons with mental illnesses can thrive with
diverse levels of residential support. Some just need a counselor to drop by
once or twice weekly, others needs an hour of support daily, and still others
need staff around for 6-8 hours each day. Such staff may just provide emotional
support, or they may monitor the use of medications, assist in meal preparation
or other daily living skills, and transport clients to medical appointments.
However, currently in Maryland, for programs not supported by Medical
Assistance, services are not available that provide an appropriate level of
support. Unless such programs are licensed by the State as Assisted Living
programs with 24 hour support, they essentially cannot exist. And the Assisted
Living programs that do exist are primarily oriented toward the elderly, provide
a level of supervision that most adults recovering from mental illnesses find
oppressive, and, of course, are more costly than needed for persons who are not
suffering from physical disabilities.
Just last month, I was consulted by one of our community’s wealthiest families
to find a supportive residence for their son who was being discharged from a
private hospital. No suitable program was available in the Maryland suburbs at
any price and we had to temporarily house this troubled man in a bed and
breakfast designed for tourists. And, on the other end of the spectrum, I have
worked with a recovering citizen who labors nearly 35 hours a week as a low-wage
grocery courtesy clerk. Making too much to qualify for Medicaid, he needs only
minimal support, but cannot find a suitable residential program.
Thus I strongly urge this Committee and our Legislature to pass HB 847. At
minimal expense to our State Government, this Bill will enable both non-profit
agencies and proprietary companies to establish hundreds of beds in appropriate
residential facilities across the State which can be used by citizens with
mental illness who are not covered by Medicaid. Such services should pay the
costs incurred in this bill many times over in reduced hospital utilization and
jail tenure as more economical levels of support prevent relapse for many
recovering persons. Further, by providing a means to obtain residential support
without Medicaid, more citizens with mental illness will be encouraged to pursue
employment rather than governmental assistance.
Testimony by Joel Kanter, MSW, LCSW
February 25, 2005
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