Disability center closure marks end of era, start of battle
POLK, Pa. (AP) — With its clusters of stately red-brick buildings and manicured lawns, set amid the farm fields and state game lands of Venango County, Polk Center almost looks like a college campus.
Instead, it is one of the last vestiges of Pennsylvania’s once-vast system of institutions for people with disabilities.
And with the state Department of Human Services’ recent announcement it intends to close Polk and move out its last few hundred residents in roughly three years, it’s also at the center of a fight.
Most disability advocacy groups have hailed the planned closure as another needed step toward closing all remaining large-scale institutions. People with disabilities are better served, they argue, in home- and community-based settings rather than the isolated facilities of the 19th century.
But many employees of the facility, family members of residents, and local elected officials have vowed to fight the closure. They argue that Polk has been the home of many of its residents for decades, in addition to being a key source of economic activity and more than 700 jobs in a rural part of Pennsylvania. They also argue residents are already part of their local community and lead fulfilling lives there.
“The little borough of Polk has embraced that institution basically from day one. The people of Polk Borough and the residents of Polk Center, they’re a family,” said Vince Witherup, a Venango County commissioner.
Though rumored for years, the announcement last month that Polk would close, along with White Haven State Center in Luzerne County, was still somewhat unexpected, said Tammy Luce, a residential service aide at Polk for close to nine years.
“We’re all concerned because we’re losing our jobs. But that wasn’t our main concern,” said Luce, president of the American Federation of State County and Municipal Employees Local 1050, one of several labor unions representing Polk workers.
“Our main concern was our family is being ripped from their homes. There’s a majority of (residents) that have lived there around like 45 years. And that’s all they know.”
Luce and her colleagues help residents with tasks such as dressing, bathing, assisting with feeding, toileting, or helping them get to jobs either in the community or on the grounds, such as in the greenhouse or concrete shop.
“I’ve been with my group for nine years. I know them. If something’s wrong . I look at them, and I know something’s wrong,” particularly with individuals who can’t communicate verbally. “People in a group home, the turnover rate is so high, they’re not going to know these individuals like we do.”
“This decision is so disruptive, it appalls me that we’re even here talking about it,” said State Rep. R. Lee James, a Republican whose district includes the center.
One of Polk’s longtime residents is Sharon McCabe; her sister Irene McCabe is president of the Polk Center Parents, Family and Friends.
Sharon has lived at Polk for 66 years.
“She does not need a group home. She lives in a group home now. It is called Meadowlark and it is part of the Polk Center campus of group homes,” Irene McCabe wrote in an email.
Her sister is “surrounded by people who know her and like her and look out for her and her best interests at all times. She gets out plenty, she goes to fun places a lot. When I visit we laugh and feel close.”
Family members who advocate for keeping the centers open testified earlier this year in Harrisburg, arguing the centers were the best place for their loved ones due to serious circumstances such as self-injuring behavior requiring constant care or supervision.
But Pennsylvania, like other states, has been moving away from such institutions for decades.
A dark history
When it opened in 1897, Polk was the first state-run institution in Pennsylvania for people with intellectual disabilities, though at the time it was known as an institution for the “feeble minded.”
Its bucolic location served in part to keep its residents away from the rest of society, said Celia Feinstein, executive director of the Institute on Disabilities at Temple University.
“When you look at a place like Polk, it’s pretty far away from any big number of people,” she said.
At the time, there was a view that people with disabilities had to be segregated, isolated, and “bred-out” of the general population, said Dennis Downey, emeritus professor of history at Millersville University.
Many residents came there as children.
Polk in its early days was completely self-sufficient — farming its own food, with dairy cows, a butcher, a bakery and everything it needed on site, including a cemetery.
At its height, it had about 3,500 residents.
A movement toward deinstitutionalization began slowly in the 1950s with family and individual advocacy, and grew into the 1960s with legal challenges, court rulings and more public advocacy, said Mr. Downey, who is working on a book about Pennhurst, a now-closed institution in eastern Pennsylvania.
“We’re all concerned because we’re losing our jobs. But that wasn’t our main concern.”
— Tammy Luce, residential service aide at Polk
There were also horrifying instances of abuse, at Polk and elsewhere.
Bob Nelkin, then a staff member at the Pennsylvania Association for Retarded Children (now ACHIEVA), was part of a group of parents and other advocates who would drive around the state, making unannounced visits to institutions. They would insist on being allowed to see the director and having access to the facility.
During one 1973 visit to a Polk cottage, he wrote that it “has to be the worst in our State school and hospital systems. It is a hell hole, a zoo, a pig sty.”
“Residents were tied to their benches,” he wrote. “The stench (a combination of urine, feces, and body odor) was unbelievable. There were no attendants actively engaged in a program for these residents. The noise level and confusion was overwhelming.”
“We kept seeing things that were totally outrageous, that offended us as human beings,” Nelkin recalled.
Perhaps most famously, in 1973, the group saw people in cages at Polk — which led to the superintendent’s firing, a firestorm of controversy and, ultimately, changes.
But patient deaths, staffing concerns, a Health Department report that showed shocking conditions — such as instances of patients with broken bones being left untreated and patients who were given stitches or underwent stapling procedures without anesthetic — continued to generate controversy in the 1980s and 1990s.
Even amid all that, however, a number of family members of Polk residents said they were happy with the care their loved ones received there.
The center was threatened with the loss of millions in federal funding in the 1990s but ultimately corrected its problems and remained open, though the number of patients continued to decline as deinstitutionalization accelerated.
From the mid-1980s to 1999, the state closed nine centers for people with intellectual disabilities or ID units that were part of mental health facilities. With the planned closures of Polk and White Haven in the coming years, only two state centers will remain.
“As we move or transition folks to the community, we’ve got to know this history,” said Downey. “Otherwise, we are setting ourselves up for new problems.”
Nelkin said there will always be a need for “eternal vigilance about the quality of care” for people with disabilities.
Still, he believes, “how we care for people with intellectual disabilities is one of the greatest improvements in society in the last 50 years.”
About 700 people still receive care in state institutions, but 40,000 Pennsylvanians with intellectual disabilities now live in community-based settings, according to state statistics.
Nevertheless, some individuals are on a wait list to receive home- and community-based services. Additionally, community services such as group homes have struggled with a shortage of qualified workers, in part due to low wages and how the state reimburses providers for services.
“We do have a workforce crisis, no doubt . the answer isn’t to keep people in the institution, but to build a qualified, well-compensated work force,” said Temple’s Feinstein.
Groups that support the closure say the needs of all Polk residents can be met elsewhere.
“While every person’s disability and need for services are different, I’ve never met a person in a state institution who couldn’t live in the community with appropriate supports,” Steve Suroviec, president and CEO of ACHIEVA, said in a statement thanking Gov. Tom Wolf for the planned closures.
A shrinking number of residents
On a recent afternoon at Polk, a handful of residents were working in the concrete shop, which makes items such as garden gnomes, for sale in a store open to the public. In the greenhouse, which is also open to the public, residents were watering plants and sweeping floors.
In one of Polk’s residential “cottages,” several residents were hanging out in a common area. One resident, shaking hands with a group of visiting legislators and reporters, told them, “Save Polk Center!”
But much of the 2,000-acre facility isn’t being used any longer. The fields that used to grow the institution’s food are leased to local farmers. A nine-hole golf course is overgrown. Large homes that were formerly for the director and other staff sit vacant.
The number of residents has declined over the years; only 194 now remain. The average age of a resident is 62, with an average length of stay of 47 years.
The average annual cost of care per resident is $409,794 at Polk, many times what it would be in a smaller, privately run group home, though state officials have emphasized their decision to close the center is not based on cost, but on the better quality of life residents can have in community settings.
“As we move or transition folks to the community, we’ve got to know this history. Otherwise, we are setting ourselves up for new problems.”
— Dennis Downey, emeritus professor of history at Millersville University
“Having an intellectual disability does not mean a person is incapable of making decisions, contributing to their community, or exploring lifelong learning opportunities. Community-based settings honor the inherent value of every person and empower individuals to choose the direction of their own lives,” Human Services Secretary Teresa Miller said in a statement announcing the closure.
DHS officials also have pledged not to rush the process and have said no resident will leave “without a destination of their choosing and a fully developed plan that meets their physical, emotional, social and mental health needs.”
Department officials, citing last year’s closure of Hamburg Center in Berks County, say many former residents are now closer to family, and surveys show people are happy with their new homes.
“The people who benefited the most from deinstitutionalization were the people with the most significant support needs,” according to the Pennhurst Longitudinal Study of people who left that institution, said Feinstein.
“I don’t buy, ‘Too old, too disabled, too behaviorally challenged.’”
Information from: Pittsburgh Post-Gazette, http://www.post-gazette.com