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Security check. She is frightened that she will be needed at home at times and would lose wages due to this. If she could get home care for her husband and son daily, she could hold down a good job. Somehow, she feels, she cannot give up her Social Security check. So they went on welfare. (With age differences, this type of a case is frequent.)

CASE NO. 4

The husband has been ill for many years. Both are 67. She keeps on working to support him. She could use the added income from her Social Security, but is earning too much to qualify. Her sister who married a very wealthy man, who is also, now an invalid, gets her Social Security every month, while they enjoy trips to Europe, etc. Makes one wonder!!!

The sister is 65. (This case can be multiplied numerous times in many other instances.)

ITEM 2. A SHORT RANGE PROGRAM FOR LONG RANGE BOARDING HOME SUPPORT AND DEVELOPMENT, SUBMITTED BY DR. ROBERT J. MCCARTHY, UNIVERSITY OF NEW MEXICO, ALBUQUERQUE

BUDGET

This grant proposal includes two alternate proposals-Project A and Project B. Understanding of the budget breakdown may necessitate reference to the Projects' timetables.

To each yearly budget must be added 25.76% of salary and wages for overhead/ administrative costs as required by the University of New Mexico and as approved as budget items by federal grants. Part of the 25.76% may be negotiated for in-kind match.

The budgets may have to be revised slightly to consider inflationary rises not accounted for in the initial preparation of the grant in March, 1974.

(Draft proposal continued on p. 1130.)

BUDGET-PROJECT A

1st year:

3 staff (mental health workers III, IV and/or V and licensed practical nurse) at $6,400.. 1 clinical psychologist (planner-coordinator):

25 percent time...

15 percent fringe.

Total.

Consultant Fees:

Occupational, physical, corrective and/or recreational therapist etc., at $10 per
hour, for 50 hrs..

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Local mileage...

Miscellaneous: Part time space rental and phone; typewriter, stationery, printing, et cetera..

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Total.......

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23, 730

8,000
989

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Income. Consideration, but no estimate, may be given to reimbursement for approved psychiatric/psychological treatment during part of the project period. It is also suggested that consideration be given to the possible realization of one of the objectives of the project, i.e., supplemental support to boarding home operators by the health and social services department or the department of hospitals and institutions. As such, reimbursement for operator training may be obtained, during the 3d project year.

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Food at $700 for 6 mo of operation..

Rent at $300 per month for 12 mo as used for office, staff training, and renovation.

Utilities including phone at $100 per month.

Equipment, household furnishings (see attached).

Renovation: including rugs and drapes, safety equipment e.g. handrails, ramps, et cetera..

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10,000
6, 400

5,800

5,400

5,000

2.479

35,079

5, 262 40, 341

1,375

41, 716

41, 716

4, 200

3,600

1,200

8,000

3,000

600

2,839

2,500

67,655

Possible income.-12 residents receiving SSI: $140-20 for personal use=$120 per month program timetable: 6th-8th month: progressive enrollment of residents; 8th-12th months full enrollment. 12 residents X $120 per mo= $1,400 per mo. $1,400 per month X 5 mo = $7,200. Plus $1,400 from initial 2 mo= $8,640. Unknown amount generated through possible psychiatric services. Possible budget: $67.6558,640 = $59,015.

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Possible income.-12 residents receiving SSI of $120 per months X 12 month $17,280. Plus unknown SSI increase. Plus unknown reimbursement for psychiatric services. Possible budget: $67,596-17,280=$50,316.

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Possible income.-1st 6 mo. similar to last 6 mo. of project year. Possible budget: $75,063 - 8,640 = $66,423.

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Possible income.-It is suggested that consideration be given to the possible realization of one of the objectives of the project, i.e. supplemental support to boarding home operators by the health and social services department or the department of hospitals and institutions. As such, reimbursement for operator training may be obtained during the 4th project year.

41-055-75

INTRODUCTION

During the preparation of the final draft of this proposal, the following story appeared in the APA Monitor (The American Psychological Association, March, 1974):

NEW YORK TOWN BANS MENTAL PATIENTS

Long Beach, New York . . . passed an ordinance . . . that bans anybody requiring "continuous" psychiatric, medical or nursing care, or medication from being registered in any of the city's facilities... Carried to its logical conclusion, the... law would treat former mental patients (and present mildly or moderately disabled individuals, ed.) as permanent lepers and would cripple the progressive movement toward community-based outpatient care. (The rate of admissions to New Mexico State Hospital from Bernalillo County has decreased from 27% prior to the development of a community based program to 4%, while the number of applicants for service has tripled, ed.)

The article points out that the city's intention is not to ban mental patients but to regulate and supervise the city's 30 odd hotels and rooming houses which were never intended to be health care facilities and many of which are substandard. Apparently, however, the city is regulating people and not substandard facilities as no positive support or closing of substandard facilities is indicated. Proponents of the law reportedly also represent some senior citizen groups who shouldn't be forced to live with mental patients. The point is elaborated on in the article with the consideration, would any one put his mother in the same room with a mental patient. Obviously not; but, perhaps as equally important and in reference to this proposal, would anyone put their mother in a substandard rooming house or "hotel" or situation which does not consider the more intangible aspects of quality living-social stimulation, opportunities for a sense of self worth and competence. (The complete text of the article is an addendum to the proposal.) At another level, consideration should be given to reference in the 1970 U.S. Government Census Report regarding persons in group living situations. One reference, listed along with prisons, is to inmates of homes for the aged-lacking further definition, it is assumed reference is to nursing homes as rooming houses are also listed. Nonetheless, it is felt that the use of the term inmate carries a popular negative connotation although the denotative reference is also not necessarily complimentary: one of a group occupying a single residence; especially a person confined in an asylum, prison or poorhouse. (Today's nursing homes are indeed costly and the poorhouse can be where you "end up" after being in one; "confined" implies, as against one's will which is not necessarily true of a person who voluntarily uses a nursing home facility.)

More specifically in regard to the project, it is assumed that any agency providing human services develop their intervention plan with due regard for both the figure and background aspects of the client. As an example, it would be foolhardy for a client to be prescribed a medication and have no financial means of obtaining it, i.e. the agency would refer or assist the client to or with resources, eg. an HSSD application. Similarly, agencies such as mental health, various medical programs and rehabilitation programs develop intervention plans, but unintentionally may overlook a possible variable which can seriously jeopardize the plan (or even limit potential clients from seeking services). This variable is the client's psychological and physical residence which, for many, is a boarding home. With due respect to the fine boarding home operators, general public opinion appears to be pessimistic about the quality of living provided and negativistic about the intentions of operators. No known local project has existed which attempts to offer positive consideration of operators' "side of the story." The proposed project is such an attempt: Project staff will be trained; work in boarding homes or operate one for a specified period; provide psycho/social services; gather management and other data; analyze data and develop a Boarding Home Operations Training Package for statewide use that focuses on fiscal/physical management and Physical/Psychological Care Development. If, as indicated by the data, further positive support is necessary, the data will be presented to possible resources, e.g., the Health & Social Services Department and/or the Department of Hospitals and Institutions.

Many boarding homes contain a mixture of older and younger residents. The Project will: 1) Focus on this typical boarding home resident pattern as best as possible and 2) Be considered as part of the development of a comprehensive (mental health) program on aging.

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