Library Collections: Document: Full Text

By the same token I still see frequently references to the development of private facilities which seem to be predicated on a far too unrealistic appraisal of cost factors that can and will develop over the life span of a fully dependent mentally retarded person.

Sending one's child to a private institution should certainly remain the privilege of those who can afford it, just as a few families with intellectually normal children prefer to send their youngsters to a private school; but I am greatly concerned when I see local associations use their precious time and resources for such projects which can only serve the few in preference to meeting the realistic needs of the many.

I see an urgency for this Association to develop a clearer understanding of how our Nation's programs of social insurance and public assistance fit into the economics of mental retardation. I certainly believe strongly in the benefits of a supplemental private insurance program but in contradistinction to mental illness where we have increasingly the possibility to return the patient to his accustomed productive life after a brief intensive period of in-patient or out-patient treatment that could be covered by a hospitalization plan, the life-time chronicity of mental retardation makes full coverage by private insurance an economic impossibility.

NARC will not be able to lay claim to being the national voluntary citizen organization speaking for the field of mental retardation if we continue likewise to overlook the social frontiers of mental retardation. The President's Panel Report (and I sincerely hope there is not a single person here in this audience here tonight who has not taken time to read this report in its entirety most carefully and repeatedly) has certainly amply documented the extent to which mental retardation is related to socio-economic and cultural causes alongside of the Biological factors, to us much more familiar. Socio-economic factors and cultural deprivation may sound to you like fanciful theoretical formulations but they refer to things that happen in your own communities and it is certainly your responsibility to point them out to your fellow citizens and insist on appropriate civic action programs with just as much conviction as you put into your efforts to persuade state health departments to promote universal PKU testing programs.

I am well aware that we have in our membership groups those who would rather avoid being in touch with public welfare programs lest they might get "tarnished" by them. To this I can only say let us not have in mental retardation a "wrong side of the track" to which we abandon those who are economically and socially deprived. You who have fought so hard the discrimination directed at the mentally retarded can hardly afford to discriminate on your part by establishing your own criteria as to who is worthy of your efforts. Just as we have learned to work with the field of public health so now we must recognize our responsibilities in the field of public welfare (and, I might add parenthetically that I have taken occasion to point out to the public welfare field their responsibilities to understand better and meet more effectively the needs of the mentally retarded and their families.)

Another issue you must be prepared to meet squarely in the future is also closely related to the Report of the President's Panel on Mental Retardation. I refer here to the emphasis on shifting from state care to community care of the mentally retarded. I do not mean to be sarcastic when I say that this is a noble purpose, but I do mean to imply that in this area we will face a long road from intent to realization. My concern pertains to the need to look for quality as much as for quantity, in short to the urgent need for us to help establish standards and insist that these standards be safeguarded in developing community programs through appropriate application of licensing, supervision and consultation from the proper state departments. May I remind you as I recently reminded the White House Conference on Mental Retardation and other professional groups I had the privilege to address that we should have learned from long and bitter experience that it just is not so that that government is best which is closest to the people and that some of the worst abuses we have had in the field of health and welfare have occurred when counties, townships or small cities assumed responsibility for program. It has been most heartening to me to see how our Education Committee under the leadership of Dr. Baldini has formulated with clarity a policy statement as to why we cannot do justice to the mentally retarded unless the programs we sponsor and espouse encompass good standards. I am quite well aware that there is by no means common agreement on this point within our Association or even within the group assembled here and all the more I wish to leave with you on this occasion my strong conviction that to compromise with standards is to endanger our reputation and with it our effectiveness as a group to which citizens, professional groups and government agencies may look for leadership and guidance.