Cunningham: It’s not about what it costs, it’s about what people need

Editor’s note: This op-ed is by Julie Cunningham, LICSW, who is the executive director of Families First Vermont. It is a letter she sent to Gov. Peter Shumlin, Sens. Patrick Leahy and Bernie Sanders, and Rep. Peter Welch.

Dec. 17, 2012

Dear Gov. Shumlin,

Like you, I have been watching the tragedy in Newtown, Conn., and trying to comprehend how society has become completely unsafe for our children. I know that you have dedicated much time and energy to thinking about Vermont’s youth, and that you are invested in doing what you can to avoid a similar catastrophe in our state. Since our mental health and developmental services system have been undergoing major systems changes, I would like to share with you some of my thoughts about our shared concerns for our future.

As a community-based social worker for 25 years and for the past 13 years as director of a specialized service agency, I have worked closely with hundreds of families who are struggling with a child with a mental illness or a disability. I have noticed, over time, a steady decrease in services that are available for children — most notably in special education — but also in agency programming. Most families come into services at a crisis point. Prevention and outreach are non-existent. IEP and Coordinated Service Plan meetings are often uncomfortable, even excruciating, as service providers do not have enough funding to meet the needs presented. A child under the age of 19 who has a developmental disability can only receive a Medicaid (Developmental Services) waiver if there are repeated hospitilizations or the child is in DCF custody. We are a reactive system, and unfortunately our recent conversations about upcoming changes promise more of the same.

As a lifelong and generational Democrat, I am disheartened by both the national and state dialogue about caring for the most vulnerable. More and more, it is only discussed in terms of what it costs — not by what people need. My Democratic heroes are Franklin and Eleanor Roosevelt, Bobby Kennedy and LBJ. During the Depression, President Roosevelt sent the first lady to as many institutions and CCC camps (places that received federal funding) as possible, to not only insure that no fraud was taking place, but that people were being treated humanely. Mrs. Roosevelt insisted on talking with patients and participants directly, as she felt this was the only way to really know what was happening.

There is footage of Bobby Kennedy campaigning for president in Mississippi, where he sees African-American children with distended bellies. He looks at the camera, tearing up, and said “We must do something about this.” Sen. Kennedy went back to Washington and started the legislation that would become the food stamp program.

Although Barack Obama won the election, there has been almost no national dialogue on the needs of children and adults who live with mental illness, a disability or who live in poverty. The Democratic Party has minimized what was once considered its most cherished principle — that government has a responsibility to provide funding and programming to the most vulnerable.

And LBJ started, but could not finish the war on poverty. One of my social work professors was just beginning his career at this time, and was given a job to walk through neighborhoods in New York City, and find out what people needed, one conversation at a time. Funding was available to start the community programs that were identified by the people he met.

Although Barack Obama won the election, there has been almost no national dialogue on the needs of children and adults who live with mental illness, a disability or who live in poverty. The Democratic Party has minimized what was once considered its most cherished principle — that government has a responsibility to provide funding and programming to the most vulnerable.

The language has changed over 25 years. Increasingly, we now use corporate speak in human services — productivity, utilization review, efficiencies, instead of common sense conversation about what would help. While I believe that we should use research informed best practices, we must also not forget that there are real people behind the numbers. Qualitative data, which is essentially what Eleanor Roosevelt did, is just as statistically viable as quantative data.

In essence, the Republican Party has effectively directed the discourse in that we now all believe that we cannot afford human service programming. But as terrible events are playing out in our neighboring state, we must ask if we can afford not to take care of people who need our help.

I know that elementary schools around Vermont are all trying to reassure parents that there are security protocols in place and that their children are safe. But the most significant safety measure we can take is to make sure we are providing excellent and easy to access services for children and adults with developmental disabilities and mental illness. We need to increase our collective knowledge about mental health, and decrease stigma about asking for help. We need community members who know who to call when they are worried about an individual or a family, and make sure that staff that are on the front line are adequately trained and compensated for their vital work.

Governor, thank you for taking the time to read this letter. I am willing to assist you and your staff at the Agency of Health and Human Services in any way that I can, as we all strive to make a safe future for Vermont children.

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  • Moshe Braner

    While Ms. Cunningham’s concerns are laudable, to dismiss costs as a constraint is unrealistic. We do have only finite – and declining – resources. To suggest we spend “whatever it takes” in one vital area is meaningless unless one also suggests what areas we should cut spending on. We won’t make real progress until we realize that we cannot have it all. Spending on medical care, education, infrastructure, and on and on – all have limits. Where is the national discussion on the elephant in the room, our unsustainable military spending? And no, universal health coverage cannot mean that we all get all the expensive procedures that can be devised. There, I’ve now made everybody unhappy. Should have promised everybody lots of goodies instead. While printing trillions of make-believe money solely for the bankers. Then I too could get elected. Happy Cliff Day everybody!

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