This article first appeared in the St. Louis Beacon: November 21, 2008 - Billy Staggs was living in a small apartment in Wood River when things started to go downhill for him. He got depressed, and it was hard to get the motivation to clean his place or take the medication that kept the symptoms of his mental illness at bay.
"I fell in with the wrong crowd," said Staggs, 25, who is also developmentally disabled. "I had a couple of episodes. I went to the hospital, and then I came here. And it got better."
"Here" is the Madison County Sheltered Care home, an old, red farmhouse set atop a grassy hill a few blocks from Edwardsville's downtown. It's where Staggs and 24 other people live, each developmentally disabled, mentally ill, elderly or some combination of the three. And although 96,000 Madison County voters - 81 percent of the day's voters - cast their ballots to keep it open in a Nov. 4 non-binding referendum, the Madison County government is proceeding with plans to shut the shelter down next year. They say a new facility now in the early planning stage will better suit mentally disabled people in the area.
But supporters of the existing shelter say its residents are fine where they are, and that many need the kind of care it delivers, not what the county has in mind for the new place, which may never get built, they argue. They say the voters have shown they agree and that their votes should be heeded.
"It's making a mockery of our democracy, the fact that 96,000 voters are being ignored," said Larry Evans, whose advocacy group, United Congregations of the Metro East, is spearheading support for the home. "Madison County used to be a place where 'the least of us' were taken care of," Evans said, quoting a biblical passage. To him and many other supporters, that era is now coming to an end.
How a house became a home
But at a time of fiscal austerity, when county revenue is expected to drop by $2 million during the next fiscal year, operating a shelter home has become unfeasible, Madison County Board Chairman Alan J. Dunstan said after the board meeting Nov. 19, when the county's 2009 $122 million budget was approved. That vote effectively closes the home, since it doesn't include the $1.5 million from property taxes needed to support it, city officials have said. Dunstan has pledged that the facility will remain open with the help of an existing operating fund for the next several months, or as long as it takes to place its 25 residents in other facilities.
"No one is going homeless," Dunstan said. "But the home is going to close. Even if we wanted to be in the sheltered care business as it stands now, we can't afford to be anymore."
Madison County has been in the business of providing subsidized care to the needy -- be they orphans, the poor or the mentally disabled -- since the early days of the republic, when county commissioners voted to use public money to care for the children of resident Toliver Wright after he died fighting Indians. Then came the Civil War, and a family whose name no one seems to remember donated the existing shelter building and several acres surrounding it to be used as the County Poor Farm. It would serve as a subsidized home for the elderly and for tuberculosis patients in subsequent years.
But as those populations either found care or cures elsewhere, one group was left, said Steve Jellen, a retired carpenter and member of the Friends of the Sheltered Care Home, an auxiliary. "They were left with people with no where else to go, who didn't fit other, existing facilities," said Jellen, as he sat at a table in the shelter's dim activity room. A group of residents was playing putt-putt golf a few feet away. "That's why this place is important."
Inside the shelter home
Today, only the faintest hints of its grand past as a country estate can be detected among the dilapidated porches and peeling wood trim of the rambling, and ramshackle, building.
While a front door leads to a brightly lit entry way, with flowered wall paper and a cheerful television lounge complete with aviary and shining tile floors, a back door leads to its dim counterpart. Two residents, who appeared to be men in their 50s or 60s, sat dozing, their chins on their chests, in front of a television in that back TV lounge. Fluorescent tubes hanging from the ceiling cast a grayish light, and the black-and-red tile floors and narrow, dark armchairs lining the walls suggested a 1940s train-station waiting room. A cheerful employee sat answering phones and doing other work at a desk nearby, as aides dashed in and out organizing activities and exchanging light-hearted conversations with the residents among them.
Most residents appeared to be senior citizens with evident mental disorders of varying degrees, and most appeared smiling and cheerful. The two sleeping residents later joined the golf game in the main activity room. Administrators of the home, who declined to be interviewed, permitted a reporter on a recent visit to see only the public areas of the home and to take photographs only outside.
According to home records, most of the residents have been diagnosed with a mental illness, such as paranoid schizophrenia, seizure disorders, depression or bi-polar disorder. Some are also developmentally disabled. At 25, Billy Staggs is by far the youngest; about half are between 45 and 59 years old, the other half 60 to 84.
Demand for beds for mentally challenged seniors across the state is as varied as Illinois itself, said Melaney Arnold, a spokeswoman for the Illinois Department of Public Health, which regulates care for mentally challenged people. While some areas have subsidized beds that go unused, other areas don't have enough, she said. "It fluctuates.
"That said, if anyone at the (Madison County) facility needs help in finding a place to live, they can contact the Department of Public Health, and we'll help them," Arnold said.
Dennis Nobbe of Granite City says he's not sure where his 70-year-old sister, who has schizophrenia, will go once the home closes. Nobbe said that the nursing homes for the elderly he's checked out during an open house organized by the county didn't seem right, since his sister isn't physically limited enough to require their round-the-clock, hands-on care. Nor did the mental health facilities he's looked into, he said. "She's hard to qualify (for another, existing facility) because she's not developmentally disabled, and not really aged or infirm. She's in that middle group that people seem to want to shove aside," he said.
Like several other residents, including Staggs, Nobbe's sister arrived at the home directly from a hospital stay. "It's a good stepping-stone," said Jellen. "It's a last-resort, fallback place, and people are glad it's here."
New center will foster independence
County commissioners are planning to build a 16-unit, assisted-living apartment building that they say will better address the needs of the mentally disabled, be they current residents of the shelter or not. For $500,000 annually, about one-third of what the county now pays to support the shelter home, the county will partner with Chestnut Health Services, a local mental-health-services provider, to administer the new facility and supply a mental-health professional on site full time, said Dr. Chris Wangard, a Troy pediatrician and member of the Madison County Board who supports the shelter home's shutdown.
The planned facility, for which a Collinsville site has been selected and is undergoing local permitting requirements, reflects what is now considered the highest standard of care for the mentally disabled, Wangard said, which is helping them to live in "the least-restrictive environment," rather than an institutional setting that encourages dependence, something that he and other county board members say the existing shelter home provides.
That means more programs that help residents develop the skills that foster independence, rather than merely recreational activities designed to occupy their time, he said. "The county should be in the business of helping people who can't help themselves," Wangard said. "The county should not be in the 'shelter care' business," such as what is provided at the existing home, he said.
Staggs sat at one of the round tables in the shelter's activity room a day after the board's vote, a copy of a local newspaper in front of him. He was reading a headline about the budget passing, and about the de facto decision to close the home he's known for over a year. After considering the details of the board's plan, Staggs agreed that someone like him, who spends much of his time volunteering at the Edwardsville Public Library, checking his email account there, and attending group therapy sessions at a local mental-health clinic, would likely do well at the kind of facility Wangard described. But it's the others he's worried about, he said.
"There are other people here who can't do anything else," Staggs said. "They're not like me."
Evans, of United Congregations, agrees. "There are residents (at the shelter) who will have to have institutional care forever," he said, who will never be independent and shouldn't be expected to be.
The voters' decision
Dunstan denies the board's decision to close the home effectively ignores the voters' will. He says the question on the ballot -- "Shall Madison County continue to provide sheltered care services in a facility licensed to house at least 42 residents?" -- was deliberately vague and designed to produce just the positive response it did, rather than present voters with the alternative home now on the drawing board.
Under Madison County regulations, the group that wins the right to put a referendum question on a ballot -- in this case, the supporters of the facility -- also wins the right to write the question. As a result, Dunstan said, some voters didn't know what they were voting for, assuming "residents" could have meant stray animals, for example.
That claim angers Evans most.
"They're associating human beings with pets," he said. "They say the people of Madison County don't know the difference.
"Now the voters know what it feels like to be a resident of the Sheltered Care Home --- what it feels like to be ignored," he said.
Susan Skiles Luke is a freelance writer in St. Louis.