Mental health: weaving the shreds into whole cloth

Editor: Michael D. Klemens is to be commended for his excellent article, "Ann Kiley of DMHDD: working with the shreds of a system," in the March Illinois Issues. He has artfully described the woes of the system — which we called a "patchwork" — and the meager results of Director Kiley's sincere and persistent efforts to improve it.

We agree that "many of the problems are financial." In fact, our highest legislative priority this spring is to obtain an increase in the state income tax. This is absolutely necessary in order to provide both decent state hospitals and sufficient community mental health services.

DMHDD is being forced by lawsuits and the threat of withdrawal of Medicaid funds to improve conditions in state facilities. Accessible community services should not be "a vision for the future." They are essential now to reduce hospitalizations and to support rehabilitation. Two very essential and scarce community resources are small group residences and services for emotionally disturbed children and adolescents. More money is needed to provide these programs, and that funding should be tied to innovation and effectiveness.

Increased financial resources, a stronger commitment to community services and thoughtful, progressive planning are all required to weave the shreds of the system into whole cloth.

      Phoebe S. Telser
      Mental Health Action Chair
      League of Women Voters of Illinois
      Chicago

Advocating state support for care of mentally ill

Editor: In your March Issue, Illinois Department of Mental Health and Developmental Disabilities director Ann Kiley is presented as worrying "more about accountability than do advocates and local providers" concerning community services. The state's own accountability warrants attention first.

Director Kiley proposes licensing community agencies to shift responsibility to them for the severely mentally ill. Unless the director demands — and gets — adequate funds to support community care, this scheme is a travesty. Community agencies can only be responsible to offer services for which they're fairly funded.

At present, undomiciled mentally ill patients are discharged from our state institutions to vacant lots and overnight shelters. Treatment of these patients is "discharged" to agencies which must serve each new referral or jeopardize state grants.

Community agencies serve 90 percent of the severely mentally ill with a declining percentage (33 percent) of a static budget. They are in no position to accept new clients or to risk a loss of funding. In fact, they are cutting staff and clients this year. The governor's fiscal year '89 budget sets the stage for more cuts next year.

If Illinois had kept up with the cost of health care over the past 10 years, it would now be spending $921 million instead of $685 million for mental health.

Because we have not maintained this base, the director's job is appallingly difficult. Hard times make hard guys. However, Kiley's plan to relieve the state of its responsibility for the well-being of our most needy citizens (responsibility it has never fully shouldered) is wholly unacceptable.

      Eloine Plaut
      Executive Director
      Mental Health Association of Greater Chicago

Saving babies in Illinois

Editor: Nina Burleigh's March article, "Why do more babies die in Illinois?", effectively reminds us that this state suffers from shockingly high infant mortality rates. We have our work cut out for us if we are to stem the tide.

The good news is that the budget proposed by Gov. Thompson in February includes funds to implement expanded Medicaid coverage for low-income pregnant women and their infants. Eligibility expansion to the federal poverty level was authorized by Congress in 1986 and Illinois participation to that level by the General Assembly last session.

The first priority this session must be General Assembly approval of the governor's spending request. An Illinois Economic and Fiscal Commission study anticipates a $3 taxpayer saving in medical costs of intensive infant care for every $1 spent in this program and the saving of many lives as well.

Second, since Congress last year extended coverage even further — up to 185 percent of the federal poverty level — Illinois must again follow suit. Third, we must reach out to all low-income pregnant women in this state and provide a full range of prenatal services including nutrition information and, after delivery, well-baby care. Last session's House Bill 294, approved by the assembly but vetoed by the governor, would have made this commitment and required coordination between the departments of public aid and public health, a critical key to reducing this state's infant mortality statistics.

      Barbara Flynn Currie
      State Representative
      26th District (Chicago)

Illinois' enterprise zones: hospitality, not hostility

Editor: As always, Jeff Brody's March article on the value of enterprise zones clearly and insightfully lays out the problems.

Based on 10 years of editing Crain's, I believe Michael Savage, deputy director for block grant assistance in the U.S. Department of Housing and Urban Development, understands the value of EZs the best. An enterprise zone is a tangible expression of a community's hospitality to business activity and economic development. Given Illinois' dismal record over the last decade of hostility to business, enterprise zones embody a powerful tool for overcoming negative perceptions.

In fact, I wish all of Illinois were one huge enterprise zone, with all the benefits and perceived benefits that entails. Then we'd get the kind of business activity and economic development that would create jobs and produce the tax revenues needed for all Illinois citizens.

      Dan Miller
      Associate Publisher/Editor
      Crain's Chicago Business
      Chicago

Clarification: Near the end of the April article, "Illinois' newspapers: Who owns the free press?," it could be inferred that no reporter in the Lee Enterprises' Springfield Bureau has ever written any news stories about W. Stephen Burgess, publisher of one of the group's papers, The Southern Illinoisan, in connection with Burgess' various positions involving state and local government. Such news stories have been written, according to Bureau Chief Tony Man.

May 1988 | Illinois Issues | 13