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Call PICK/ Before You Pack FOR SAN ANTONIO Enjoy real money-saving value, and relax at the pi A.LB E ILT C MOTEL 96 N.E. Loop Expressway Adjacent to San Antonio International Airport Color TV in every room Restaurant & Lounge Heated Pool Family Plan Free Parking ALL AT MODERATE RATES RESERVATIONS: CALL TOLL FREE 800-621-4404 In Illinois: 800-972-7200 Bob and Sara Roebuck Anchor National Financial Services 1524 E. Anderson Lane, Austin bonds stocks insurance mutual funds optional retirement program HALF PRICE RECORDS AAG.AZ IN E inefficient, personally destructive, or at best, caretaker institutions in their districts to decentralized, innovative treatment programs throughout the state which might reduce the flow of funds to their districts. Funds, once allocated to institutions became the “sacred cows” of the appropriations bills and such local interests are rarely challenged by other legislators. Such a system is “pork barrel politics” in one of its most destructive contexts. The right of a child to, care in the least restrictive, most natural environment in his or her home community is one of the pleas in Gary W. vs. The State of Louisiana, pending in the U.S. District Court in southeast Louisiana. The suit, filed by New Orleans attorney William Rittenberg, aided by the Children’s Defense Fund and the Civil Rights Division of the U.S. Department of Justice, could have wide repercussions. The suit charges top Louisiana health and welfare officials and local juvenile probation and child welfare personnel with carrying out “a consistent policy of banishment of children” to faraway, undesirable institutions. Also named as defendants are the operators of all institutions in Texas that received children from these Louisiana authorities and thus “collaborated with this policy of banishment.” Civil Rights Division involvement in the suit is expected to mean that the “right to treatment” will be introduced. In recent years, several federal court decisions, including those against Alabama state hospitals, New York’s Willowbrook School for the Mentally Retarded, and Texas training schools, have spelled out exact standards of care and treatment which are the rights of inmates of public institutions. A significant difference in the Louisiana suit is that its institutional defendants are in the private sector. Private organizations receiving public funds are increasingly being called to account. In the child-caring field, institutions receiving federal funds for the treatment of the children of military families, under Civilian Health and Medical Program for the Uniformed Services precise regulations if they are to participate. The impetus for stopping abuses in the use of CHAMPUS funds came not from litigation but from the Senate Permanent Subcommittee on Investigations. The Subcommittee chairman, Sen. Henry Jackson being paid to Texas institutions, a sizeable proportion came from CHAMPUS, and were administered for the Department of Defense by the insurance firm of Mutual of Omaha. CHAMPUS children were not only in Texas; they were spread throughout the nation. IN MID-1974, Jackson revealed “the use of instruments of torture, filth, squalor, physical abuse, the use of electric cattle prods and solitary confinement as punishment,” in facilities caring for CHAMPUS children at an annual cost to the taxpayers of $90 `million. Two nurses told Jackson’s Committee of being fired from the Green Valley School in Florida because of their refusal to participate in the punishment of children by injections of urine and carbon dioxide; and a federal auditor testified that Green Valley had overcharged CHAMPUS by $185,000 for such “care.” Officials who sent the CHAMPUS children to institutions, like many state officials, usually neither saw the institutions nor examined the standards under which’ they operated. The senders required only that a facility haVe some kind of a license, even the kind issued under Texas’ obsolete 1941 law. Until 1974 CHAMPUS paid as much as $3,000 a month for what was often very poor treatment to institutions whose fees for other patients were considerably less. The potential for abuse in the form of recruiting CHAMPUS children into institutions and keeping them longer than others is readily apparent. As a result of Jackson’s investigation, the Department of Defense made major changes in the CHAMPUS program, the most important of which are setting a maximum on payments to match those paid by other programs for the same care, and limiting the care of its charges to facilities accredited by the Joint Commission on the Accreditation of Hospitals Accreditation by JCAH, however, has not always assured the highest quality of medical care, as some findings from Texas illustrate. The Truan Committee ordered a study of institutions operated by the Texas Department of Mental Health and Mental Retardation, the majority of which are accredited by JCAH. Representatives of the Department of Public Safety, The University of Texas Southwestern Medical School and the State Department of Health did the study, and reported that: “Tranquilizing drugs have sometimes been employed to keep patients under control and quiet. In a few cases there is consistent discouragement of curiosity, creativity, independence and other qualities important to adaptation to the normal world.” The Texas House Mental Health-Mental Retardation Subcommittee made a pointed recommendation that Texas institutions accredited by JCAH abide by the standards under which they are accredited. Specifically cited were the need “to review the cause of all deaths, with an outside or consultant physician in attendance at the conference,” and to have “a physician write the admission order to the hospital … and conduct and adequately record an admission examination.” The Committee also recommended “more complete records and periodic review and management of drugs used in these institutions.” November 28, 1975 15 AUSTIN’: 1514 LAVACA WACO: 2.5N4 COLUMBUS DA LAS: 4535 AciatiN.Citat 405 =aft 5119 W. Lovato BIG =Qua 205 S. ZANG PRICES