Sixty Minutes 

One hour of psychosocial rehabilitation can be the difference between crisis and stability.

Gerry Lind (left) stands outside his new home in Boise's North End with Karen Clark (right).

George Prentice

Gerry Lind (left) stands outside his new home in Boise's North End with Karen Clark (right).

This year was supposed to be different. After seeing their Medicaid-funded psychosocial rehabilitation counseling dwindle over the last two years from 20 hours per week to 10, and then slashed again to five hours, some of Idaho's most vulnerable citizens said enough was enough.

Hundreds of mentally disabled (some needing wheelchairs or walkers) traveled from every corner of Idaho to the Statehouse on March 8 in an effort to put a face and voice to the crisis. Legislative veterans had never seen anything like it before--a public hearing featuring four-and-a-half hours of heartbreak. One after another, the disabled and caregivers begged lawmakers for financial mercy.

"We never asked for help before," said Angie Martinez.

"I'm scared to death," said Taryn Ivey.

"I'm pleading with you to represent me," said Crystal Anderson.

Even in remote Mackay, a disabled young man asked BW to write a letter on his behalf to the Legislature (BW, News, "The Face of Medicaid," Feb. 23, 2011).

"You know what I'd rather not have? I'd rather not have food," he told BW, saying he desperately needed PSR services to help stem the tide of a severe psychosis.

But in spite of the of the gut-wrenching testimony, the majority of Idaho lawmakers still decided to further cut Medicaid funding to thousands of Idaho's disabled. In fact, the Republican majority went as far as dismissing an economic forecast from Idaho's chief economist, instead choosing a much more austere baseline to justify deeper cuts.

But it turned out their numbers were wrong. On July 12, Idaho's Division of Financial Management reported that Fiscal Year 2011 closed with a surplus, and indeed the economist's forecast had a greater grip on fiscal reality than the Legislature. However, not one penny was restored to Medicaid.

Consequently, when the 2012 fiscal year began on July 1, the budget axe came down one more time on Medicaid funding for PSR services. In three short years, PSR services have been slashed by more than 80 percent.

"History will tell whether this was a session of great accomplishments or failures," said Republican Sen. Brent Hill, president pro tempore of the state Senate as the session was gaveled to a close on April 7.

Most of Idaho's disabled aren't worried about political history. They're worried about today and scared as hell about tomorrow.

Megan: Finding peace and maybe a job

There's a good reason Megan Silva didn't attend the March 8 public hearing at the Statehouse. She has severe agoraphobia, a crippling fear of public places and crowds. She is also diagnosed with bipolar disorder, attention deficit hyperactivity disorder and obsessive compulsive disorder. Silva, 37, requires a regimen of medications to function, but she said it's her PSR worker, Karen Clark of Community Partnerships of Idaho, that is her true lifeline.

"Karen doesn't know how crucial she is to my success," said Silva, beaming a huge smile while talking about Clark. "We're certainly working on my social interactions, but I have very specific goals. I'm going to do more volunteer work. I'm going to get a job. I'm going to make a decent living. I'm going to put gas in my car so I can see my children."

Silva is separated from her daughter and son, primarily because she can't afford a home where the kids can have their own bedrooms. In spite of Silva's disability, she pays child support to her ex-husband.

"I get a Social Security check for $780 each month," said Silva. "$280 immediately goes for child support. Then I have $500 to pay rent, utilities and food for the month."

Silva said she is skilled in food services. When she was younger, she was a cook and waitress but couldn't hold a job because of her slow spiral into social anxiety and fear. Now, she said, she is more confident about her future; if only she were as confident about her social services.

"I'm really worried about the cuts," said Silva. "I don't know what I would do without Karen. We're starting to work on a resume, and we're practicing interviewing techniques. Any success that I may have will be highly dependent on Karen. She keeps me focused on my goals."

Along with her goals of gainful employment and economic independence, Silva has a more overarching objective.

"My biggest goal is to find peace," she said.

Gerry: To hell and back

When Karen Clark isn't working with Megan Silva, she is working with a half-dozen other clients. One of them is Gerry Lind.

Lind, 48, was lead drummer for the rock band LeRoux in the 1980s and 1990s. The band recorded on the EMI label and produced videos that appeared on MTV. For the most part, LeRoux was an opening act, but the headliners were impressive: Edgar Winter, Foghat, Starship and Survivor. But all of it came to a crashing end, literally, in the fall of 1997.

"I was driving," said Lind in a soft voice, his eyes hidden behind dark glasses. "We were going south on Interstate 5 from Olympia [Wash.] to Portland [Ore.]. There were no shoulders on the highway because concrete barriers had been put up due to construction. Well a truck driver in the next lane turned right into us and pushed us against the barricade. We eventually ended up underneath the truck. I broke my back, neck, right arm, left leg and jaw. Our bass player was pretty banged up, too."

Lind took a very long pause and deep breath.

"And every other band member was killed."

Lind spent the next few years in a back brace. Every day since the crash, he has taken morphine and Percocet for pain. Things went from bad to worse. Two marriages failed, and he said, he was convicted of drug possession in 2003 when he "took the rap" for something his wife did.

"She even left me while I was in prison. Our daughter was put into foster care. She would be 8-years-old now," said Lind in a deep whisper.

He said he was sent back behind bars in 2007 for violating parole over an unpaid parking ticket. He has been out of jail since 2010, spending time in shelters or halfway houses.

"I was even at that halfway house when Candice Dahl stabbed that guy," said Lind, referring to a July 2010 incident at an unlicensed Boise group home (BW, News, "Halfway to Hell," Aug. 25, 2010).

Today Lind is renting a tiny home in Boise's North End, not far from Camel's Back Park. He tries not to dwell on his memories but instead concentrates on the future when he meets with Clark twice a week for PSR services.

"He's no longer the angry person I met a while back," said Clark. "Gerry understands the victim mindset, and he just isn't going to go there anymore."

Lind said he expects to be off parole by November, December at the latest. And that's when he wants to pick up his drum sticks again and start giving music lessons.

"But this isn't easy," he said. "We're putting a plan together. I can't imagine succeeding without Karen's help."

Mental illness has a familiar face in Idaho

Clark's boss, Katherine Hansen, has lost count of all of the men, women and children that Community Partnerships of Idaho has assisted over the years. She said it's easily over 10,000. PSR is just one way Hansen's team assists Idahoans. Developmental therapy, employment services for the disabled and training for home-based caregivers are others.

"I started Community Partnerships with four friends and $1,000 16 years ago," said Hansen. "Today, we have nine offices across the state and over 400 employees. We probably assisted 1,000 clients this week alone."

Hansen said a terrible irony in the current economy is that while there is less governmental funding for mental-health services, the need has never been greater.

"People end up homeless, they lose their families, they lose their relationships, they lose their jobs," said Hansen. "And then, all of a sudden, the world crashes and mental illness symptoms start to emerge and people are in crisis."

And the face of mental illness in Idaho is quite familiar.

"We've seen people come into services that not too long ago had good jobs with the state," she said. "We're starting to see people who used to be in law enforcement, who were school teachers. We're even seeing some of our former colleagues who sued used to work in family services."

"They're our neighbors or friends, our family and our co-workers," said Anna Johnson, director of mental health services at CPI. "Bipolar, depression, schizophrenia, personality disorders--they're all around us."

Hansen and Johnson slowly shook their heads when considering that many of their adult PSR clients had their services slashed from 20 hours a week to 10 to five and now to four. Even if 60 minutes a week may not sound substantial to a layperson, Hansen and Johnson said it can easily mean the difference between crisis and stability.

"I'm thinking of three clients we just saw this week," said Johnson. "When they had 20 or even 10 PSR hours a week, they were stable. But now, one gentleman has already ended up back in emergency rooms four times this year. His symptoms increased and law enforcement was involved. He even hurt a nurse in a physical outburst."

"The resulting cost to the taxpayers of Idaho is much, much greater even when you cut down just one hour of PSR services," said Hansen. "We need to track these real-life stories and encourage as many people as possible to communicate the impact of these changes."

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