On public funding and social services...

I was recently reading, almost with pain, the New York Times article about the closing of public institutions for the developmentally disabled. But somehow I cannot quite reconcile some dilemma inherent in the situation.

There is no doubt about the angst of the families of these developmentally disabled folks who have been institutionalized on public funding, requiring intensive care, one-on-one staffing, and other high maintenance services. I can't begin to imagine how it could have been liked to care for and worry over your own child or sibling or relative who might be severely autistic and aggressive or prone to becoming violent, say. It is not something that I would possibly wish it on anyone, just to get a taste of it.

If money (and funding) is no object, I'm sure too that everyone would want the best 5-star care to everyone, private room, and more. That is what the public institutions slated to close had been there for these folks for decades now. It works out for them in the past, by and large. But one has to ask, at what costs?

And so, when these institutions are closing, mandating these individuals to be moved to large group settings, families fight to preserve those facilities. Some, like the 50-year-old severely autistic man, who have never experienced anything else other than this form of living in all his life, his parents are fighting to keep it open, if not just for his own sake.

I know it sounds cold and highly calculating, but at the end of the day, there are costings that the society has to bear, and any benefits that the society could ever reap, by providing any social service. While the article doesn't mention the dollars-and-cents involved in the different kinds of services, old and new, it should have, because that would give us some idea the alternative outcome would be. Even as roughly as an estimate of how much it costs to keep the old facility opened, per person per year, juxtaposition that with what other kinds of social services could have been provided to other members in society (eg. turning the facilities into homeless shelters or to homeless families), it would have been a much easier decision to make. Say, by moving one severely mentally retarded person to a group setting can free up public funding to help three to four homeless family of four, the decision would have been a no-brainer.

In the real world when resources are limited and decisions have to be made to allocate those limited resources, that's often how it would come down to. It's far from ideal, unfortunately.

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It reminds me, years ago, when my daughter started with the swim team of the town. Kids were all small, and the town swim team is more like a communal thing that tries to be as inclusive as possible. Same goes with town traveling team in soccer for my son. Basically as long as the kids want it (or more like, as long as the parents want it), they can stay and get their field time.

And so it happens that there's this boy who also joined the swim team. He doesn't have outward trait that might mark him out, but when he gets in the water, it shows. It might have had issues with muscle control, or it could have been issues with taking instructions, or maybe more, but I never found out for sure.

In four short words, to sum it up, this boy can't swim. I don't mean to sound demeaning, but it's the way it is. When practice started and all kids start the swimming (however poorly they start out at first), but this boy would float in the pool like a dead fish. He would go on floating, face down, for maybe a minute or so until his breath ran out, and then he would wake up and started flopping in the water like he's screaming for help, gasped for a lungful of air, and then he would go back to floating face-down. Usually in an hour of swim practice, he would be able to move through the 25-yard pool maybe once.

Why does this article remind me of this boy, you would ask? Well, it comes back to limited resources, funding, and allocation of those limited resources.

For each lane in the pool with maybe six to eight kids swimming in circular fashion, there would normally be one coaching aide to teach and watch the kids. Due to the special needs of this boy, one lane was blocked out, just for him alone, pushing those six to eight kids to the other lanes which were heavily congested already. On top of that, the head coach had allocated two to three coaching aides, just for him alone because every step of the way along that 25 yards, these coaching aides would be constantly calling his name, over and above his parent who was also calling his name constantly to wake him up from the spectator stand. This was all while these two to three coaching aides who should be watching and teaching the other kids were now dedicating to one kid alone. I'm sure you get the idea of the white-glove treatment of that.

Some of the parents were visibly fuming, considering that this boy should not even be on the swim team. Given the altruistic nature of the swim team admission, he's admitted anyways. But his presence had depraved all the other kids of the teaching and resources that they should rightly have enjoyed. When that boy finally stopped going to the swim team after some two years, there was almost an audible sound of relief that resources could finally be freed up.

I have to almost admit it with guilt that I was glad to see him stop coming to the swim team too. But why did I feel guilty about it?

Was it that I was peeved that his boy was depraving other kids, my daughter included, who was squeezed out to other lane with minimal to non-existent coaching? Quite likely.

Was I disappointed that after some two years of dedicated excessive coaching staff from the swim team to just one boy, there's still no progress or improvement to this boy whatsoever? You bet I am.

Had all the resources that were dedicated to this boy so that his parents would feel good about his boy being taken care of, while the other regular kids would "sink or swim" on their own, literally? I would think so too.

This was all while the swim team, and indeed the town as a whole, had been struggling with budgetary constraint, and there had been talks of cutbacks and raising fees for everyone to cover just the basics for the swim team.

In a way, this anecdote of the swim team is like a shrunken version of the resource allocation and the cost-and-benefit issues that the NYT article has illustrated. In a perfect world when money is not an issue, we won't even be bothered about hard choices like this, but we don't live in a perfect world.

If we are to choose between caring for a 50yo man who would have little hope to contribute much to the society (while continuing to consume ever more resources from public funding), or we could free up much needed resources to help the next generations to become more productive members in society, it's almost heartless to say it, but the choice is fairly clear to me.