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Parenthood Plus: February 21, 2012

Today’s Work at Yesterday’s Prices

One of the oldest, largest and most well-respected community-based human service agencies closed on Jan. 27. Some 300 employees at Chicago’s Jane Addams Hull House Association were handed layoff notices and final paychecks and were notified of the immediate discontinuation of their health care benefits. This is a tragedy and an ominous sign.

Hull House was founded in 1889 by social worker and Nobel Peace Prize winner Jane Addams and her lifetime friend and community-activist Ellen Gates Starr. Hull House began as a home for disenfranchised citizens. The organization’s mission was “neighbors helping neighbors.” In its early years Hull House was organized to help immigrants to learn English and the principles of democratic citizenship and to improve the lives and working conditions of many of those living on the west side of Chicago. In recent years Hull House’s focus was on foster care, child care, domestic violence counseling and job training.

Hull House was a beacon for social justice. It was guided by three basic principles: (1) active and side-by-side participation with community residents in addressing local issues, (2) respect for the dignity of all individuals regardless of ethnic background, socioeconomic status, gender or age and (3) belief that poverty and lack of opportunity breed ignorance, crime and disease that are the result of financial desperation and not due to a flaw in moral character.

Hull House’s demise was the result of its over-reliance on government financing. Margaret Berglind, president of Child Care Association of Illinois, commented that “The government is asking you to do today’s work at yesterday’s prices.” I agree.

At North Shore Child and Family Guidance Center we have not seen an increase in our government contracts for a quarter-of-a-century. We are not alone. As with Jane Addams over 100 years ago, we depend on private citizens to invest in our mission - to restore and strengthen the emotional well-being of children and families. Our donors understand what is at stake. They are more than do-gooders, despite the good that they do. They understand that what we do is cost effective, saving tens of millions of taxpayer dollars by keeping troubled young people at home and out of emergency rooms and costly institutional settings.

I have reported extensively on what I believed would be the devastating outcome of New York State’s plan to restructure the financing of outpatient community-based mental health centers. Although I agreed that the over-reliance on Medicaid financing had to change, I strongly disagreed with the planners’ neglecting to provide reasonable local assistance for underinsured middle class and working poor children. State officials told me that that these families could seek help privately. My argument, based on firsthand experience, was that private practitioners would turn away troubled children that only a community-based agency had the culture, resources and wherewithal to serve effectively.

We are beginning to see the consequences of clinic reform on Long Island. In recent years several major community-based mental health clinics have either closed their doors, been taken over by New York City-based conglomerates with no community roots or transformed their outpatient operations into per-diem factories with no salaried employees. Much of this has happened under the radar.

Was it the intention of the New York State Office of Mental Health to shrink the system of care? Although it is not their job to keep providers in business, it is their responsibility to ensure ample access and consumer choice and to make sure our most vulnerable citizens - our children - get care, regardless of their family’s economic status.

I am certain that Jane Addams would have agreed.