Gotham Gazette

The Place for New York Policy and politics

Topics

Topics

In The News: Substance Abuse Treatment for the Developmentally Disabled


It is estimated that fifteen percent of those with developmental disabilities are addicted to drugs or alcohol - the same as the percentage in the rest of the population. In New York City, this translates to about 2,000 people, though the numbers may be much higher. According to a study released in 1999 by the National Association on Alcohol, Drugs & Disability, the incidence of substance abuse is growing among those with disabilities at two to four times the usual rate.

But getting help is a lot harder for someone with a developmental disability for several reasons. While an abundance of treatment programs exist for substance abuse, very few address the unique needs of those with cognitive difficulties. Despite the Americans with Disabilities Act, there has been a lag in modifying treatment to accommodate this population. In terms of social service provision for the developmentally disabled, there is scant screening for substance abuse, and frequently, a lack of awareness about the problem. Moreover, there are disincentives in terms of funding system requirements.

Deborah Lombardi is the Coordinator of Sobriety Services, the only day treatment program of its kind that serves people with developmental disabilities and substance abuse problems. According to Ms. Lombardi, drinking affects someone with a developmental disability profoundly. In the substance abuse field the Jelenick scale is commonly used to demonstrate the downward spiral of alcoholism. "Our people get there much quicker," Ms. Lombardi explained. "The results are devastating."

Sobriety Services, a 10 year-old program at Union Square in Manhattan, is part of the Association for the Help of Retarded Children (AHRC). Through individualized therapy, medical and psychiatric counseling, and a guided 12-step program approach, AHRC's Sobriety Services works with 100 developmentally disabled men and women, both adolescents and adults, in their outpatient alcoholism clinic.

Modifications from mainstream substance abuse treatment includes smaller groups; special materials that explain the literature (including the 12 steps) in pictures and concrete language; alternative avenues of expression, such as art; and a supportive community that includes others with similar disabilities.

Donna Mae is forty years old, from Brooklyn, with a 13-year old daughter. As a child, Donna Mae ate plaster containing lead paint. As a result, she is cognitively impaired, cannot read or write, and has difficulty measuring time. She starting smoking marijuana in her mid-20's and then her sister introduced her to crack. Her sister was able to stop, but Donna Mae was not.

Last December, Donna Mae went into her fourth detox. This time when she got out, she followed it up with the Sobriety Services program and recently celebrated 90 days drug free. "I'm proud of myself for getting my 90 days," she confided. "I never did it in my life. My daughter is proud of me. I just feel good."

Carl is 37 years old, from the Bronx, and recently counted his 253rd day off alcohol and drugs. "This place is keeping me out of jail and on the right track," he volunteered. "Everybody here, we're like friends. Without this place, I'd still be out there using."

Carl, mildly mentally retarded, was suicidal and living on the streets before he got sober. He had tried other programs, but without success. "Here it's different," he said. "It's like my family. " Carl goes to regular Alcoholics Anonymous and Narcotics Anonymous meetings on the outside, but says he feels safest at the meetings held at Sobriety Services. "I feel more secure here."

Lynda Sounds Off:

Unfortunately, AHRC's Sobriety Services stands alone in NYC and they can only serve 100 people, It is also a day program, not a residential treatment program.

"There are only 12 beds in the whole state set aside for residential treatment of people with developmental disabilities and substance abuse problems," said Ms. Lombardi. "The state needs to recognize this unserved population. We need residential inpatient halfway houses where people can live and be in treatment."

Lombardi suggests a collaborative effort between AHRC's Sobriety Services and existing residential treatment programs. "I'd love to collaborate with a residential treatment facility that would be willing to accept training from us for this specialized group and devote resources to service this population."

A collaborative effort with an existing program makes sense economically as well; completely replicating existing treatment facilities would be very costly.

Funding sources, however, often discourage such collaboration by their distinct focus, such as mental retardation or substance abuse, not allowing for cross-over services or not understanding the need for modifications when dealing with a dual diagnosis. A task force is needed, made up of people working on all sides of the issues, to better integrate these distinct service systems. Without some form of collaborative action, people like Donna Mae and Carl just won't get the help they need.

 

Private Child Welfare Agenices


A panel appointed by Federal District Court judge Robert J. Ward to advise the Administration for Children's Services issued a report in October recommending that the City tighten its supervision of private child welfare agencies. Judge Ward established the panel as part of a 1998 settlement of Marisol v. Guiliani, a class action suit that sought a major overhaul of the City's foster care system. Foster care for most of the 37,000 children in the system is provided by 60 private agencies under contract to the City. The Marisol panel contends in its new report that private agencies do not clearly understand what the City expects of them. "What happens to kids in care depends, to a large extent, on how well the City selects, oversees and supports these agencies," said Douglas W. Nelson, head of the panel and president of the Annie E. Casey Foundation, which is based in Baltimore. While praising the current management team at Administration for Children's Services, Nelson said City oversight needs improvement . "Right now, the tools used to asses private agencies do not sufficiently reinforce quality practice, family involvement, neighborhood-based services or permanence - all things ACS sincerely and correctly want to promote."

Farber Sounds Off:

Until this decade, the City renewed its contracts with foster care agencies without regard to agency performance. It has taken several significant steps towards holding the 60 foster care providers accountable, but has fumbled its attempts to make its new accountability system meaningful. The City rates contract agencies on how often they file case records on time, for instance, but not on whether they work effectively with the parents of foster children. The Marisol panel is right on target when it urges the Administration for Children's Services to judge the performance of those practices it values most.

Peggy J. Farber is freelance journalist specializing in children's issues. Her reporting on conditions of NYC children has appeared in City Limits Magazine as well as on National Public Radio. 

A Strategy For Paving The Way To Fewer Traffic Fatalities


800px-WTM3 Gnarly 0004

ALBANY, N.Y. — Almost as many people will die in New York City each year in traffic accidents as are murdered. The city’s own stats show that traffic deaths involving pedestrians, bicyclists and drivers went up 23 percent from June 2011 to July 2012 — 236 to 291 — and yet it remains a struggle for the city to set policy to deter the unsafe behavior that can contribute to these fatalities.

What stops the city from enacting measures to stop traffic carnage? In one word: Albany.

For decades the city has had to defer to Albany to address key policies from the way rent control is set to speed limits. The state Constitution grants a degree of self-governance — known as home rule — to the city and all municipalities across the state. But, often, city lawmakers have had to press the state Legislature to grant home rule on a raft of policy issues.

Mayor Michael Bloomberg, for instance, got home rule to take over the city’s education system. Yet, for every territory of policy that city lawmakers are able to grab back from the state, there is still plenty that advocates and officials say remains outside of city control.

With a new mayor entering office in January, a number of advocacy organizations are calling for home rule to set long-gestating policies that affect everything from how elections are run in the city to affordable housing.

Advocates believe that Mayor-elect Bill de Blasio will use his political skills and connections to be more aggressive in pressing Albany for home rule. Nowhere, though, is the fight for home rule as clear and evolved as the one for increased street safety.

The importance of reducing traffic fatalities was further emphasized during the announcement of Bill Bratton as the next police commissioner.

"It is ironic that even as the death totals have declined dramatically with violent crime in this city, this year the number of people killed on our streets — pedestrian and traffic — will almost equal the homicide total," Bratton said last week.

HOME RULE AND SAFER STREETS

De Blasio has already sent a strong message to transportation advocates that he plans to deal with traffic fatalities with his “Vision Zero” strategy for reducing fatalities. Key to that strategy is getting home rule.

In his campaign’s transportation plan, de Blasio said he would “stop waiting on Albany and fight for home rule” so the city can “install red light cameras and speed enforcement cameras around hundreds of schools and senior centers.” He also promised to “establish more 20 mph zones in residential neighborhoods, so kids and seniors can walk their streets safely.“

The city has long battled the state for control of its own destiny — and by long we are talking Teddy Roosevelt-long. “Teddy Roosevelt was the first Assemblyman to a get home rule bill passed,” said State Sen. Brad Hoylman of Manhattan. That was in the 1880s. The current home rule policy was adopted in 1963.

{pullquote}”All the cities we compare ourselves to around the world rely on automated enforcement,” said one advocate for speed cameras.{/pullquote}

Gerald Benjamin, professor of political science at SUNY-New Paltz and an expert on the state Constitution, said the battle between city and state for control has been going on “forever.” In the late 19th century, he said, the two levels of government battled over the creation of police and park districts in an attempt to woo voters and control patronage. The battles continue to this day in other forms, but the state has the legal advantage whenever issues come before the courts.

“You can view New York City politics as city politicians at the state level fighting New York City politicians at the local level for control over the city,” Benjamin said.  “This isn’t a question of home rule — it is really a question of policy.”

The difficulty in deciding city traffic policy became extremely apparent last month as the City Council tried to pass legislation to reduce the city speed limit.

Council Speaker Christine Quinn announced that Councilman David Greenfield of Brooklyn would be introducing a bill to reduce the city speed limit to 20 mph and that the city’s legislative branch would push to pass the bill by the end of the year. But problems quickly arose. The city Department of Transportation told the Council that reducing the speed limit would conflict with state law.

State law requires that streets that aren’t school zones must go under further adjustment before the speed limit is dropped to 20 miles per hour. So Greenfield tinkered with his bill to lower the speed limit to 25 miles per hour on one-way streets that don’t have more than one lane of traffic — not the sweeping change advocates were looking for.

The battle to reduce speed limits will now go to Albany where advocates also want to expand on a pilot program for speed cameras that was approved late in the session this year.

STRUGGLE FOR AUTOMATED TRAFFIC CAMERAS

After a decade of fighting with Albany, state lawmakers finally approved a simple pilot program for automated traffic enforcement cameras back in June.

Upstate legislators were major impediments to the passage of the home rule message — which would allow the city to install the cameras — due to concerns over civil liberties and the concerns of the law enforcement lobby.

Transportation Alternatives has issued study after study showing that most drivers don’t obey the city’s 30 mph speed limit and that it has lead to a rising number of fatal crashes. The studies also show that pedestrians have an 80 percent chance of surviving if they are hit by a car traveling at 30 mph as opposed to a 98 percent chance of survival if the car is traveling at 20 mph.

The pilot program established a five-year program that allows for the installation of 20 speed cameras around schools in the city. Drivers that violate the speed limit are fined $50.

”All the cities we compare ourselves to around the world rely on automated enforcement,” said Juan Martinez of Transportation Alternatives. “So we know it is effective. I’m glad we have cameras at 20 schools but there is no need to test it. This technology has been working for decades in DC, Portland, and Boulder. A rapid expansion of this program is going to be necessary to save lives.”  

Last session it was hard to get a straight answer out of legislators who controlled the fate of traffic cameras about whether it would come to a vote. Sen. Marty Golden of Brooklyn was thought to be very influential in the Republican caucus and be key to the bill's fate. Golden dodged the Gazette’s questions about the bill a number of times but as session came to an end advocates say Golden changed his mind and decided to back the test program.

During the episode, Mayor Michael Bloomberg tore into legislators for failing to act on the measure — and recommended reporters give the phone numbers of legislators who didn’t back the pilot program to the public.

“Maybe you want to give those phone numbers to the parents of the child when a child is killed,” Bloomberg said to reporters. “It would be useful so that the parents can know exactly who’s to blame.”

Opponents in the Legislature have questioned the effectiveness of the cameras, some are concerned about civil liberties aspects of using cameras and The Patrolmen’s Benevolent Association — the union that represents many police officers — lobbied against their implementation saying that more money should be spent on hiring police for traffic enforcement.

Hoylman, a supporter of the speed camera pilot program, says he thinks a push from de Blasio could help change minds in Albany and give the city the discretion over transportation policy.

“The mayor will be approaching this issue from a progressive democratic place. He is concerned about civil liberties and how this data will be used so it could help change minds,” said Hoylman. He said that “to the extent de Blasio makes this a priority it will be extremely helpful.”

Benjamin said that whether the state Legislature ultimately supports home rule messages at de Blasio’s request comes down to politics. “It depends on their predisposition to support de Blasio, based on his power, his popularity and the policy he supports,” he said.



Print Friendly and PDF

Editor's Choice


Gotham Gazette: New York Voters Approve $4.2 Billion Environmental Bond Act
New York Voters Approve $4.2 Billion Environmental Bond Act
Gotham Gazette: 
New York City Voters Approve Racial Justice Ballot Measures
New York City Voters Approve Racial Justice Ballot Measures
Gotham Gazette: 
Housing Development in New York City Slows to a Crawl as Officials Debate Tax Incentives
Housing Development in New York City Slows to a Crawl as Officials Debate Tax Incentives
Gotham Gazette: 
City Council Examines Low Voter Turnout, Moving Local Elections to Even Years City Council Examines Low Voter Turnout, Moving Local Elections to Even Years