密歇根新闻广播 年迈父母害怕死亡 只因担心后代无人照顾

Major changes could be coming tomorrow in the services for people living with a mental illness or a developmental disability in Michigan.

Tomorrow, state lawmakers are expected to release their final budget for fiscal¹ year 2017-18 for the Department of Health and Human Services.

That budget will reveal if Republicans have chosen to shift control of mental health funding – which amounts to nearly $2.5 billion in annual Medicaid payments – away from public mental health organizations, and transfer it to private insurers.

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For more than a year, there have been many, many discussions about this. The state convened² what's called the Section 298 Workgroup to come up with recommendations for the legislature. So-called Affinity³ Groups were also held across the state to hear the ideas and concerns from consumers and their families.

For parents of children with disabilities, this is a deeply personal issue. Many of them, like Bob White and Gail Marsh⁴, work hard to advocate on their children's behalf so that they can get the mental health services they need to lead healthy, happy and productive lives. They both joined Stateside to talk about their struggles and successes with the state's mental health care system and why they are worried about the prospect⁵ of changing the system their children rely on.

White is the father of two sons who are on the autism spectrum⁶ and he lives in Clarkston, and Marsh is the mother of an adult daughter who has Down Syndrome⁷ and she's from Grand Rapids.

For White, this has been an issue close to his heart for more than four decades. His oldest son, Fred, is 46 years old, and his younger brother Michael is 32. The White family has experienced Michigan's mental health system before there was widespread care available. According to White, when Fred was diagnosed with autism 43 years ago, there was no "playbook" for parents to follow.

Fred has lived in a small group home for the last 16 years, while Michael currently lives in an "independent supported" apartment and has a job.

Marsh's daughter Kayla is 27, and has been involved in Michigan's mental health care system for nine years. When Kayla turned 22, her independent spirit drove her to move out of her parents' home to start on her own path, like many young adults do. She currently lives in a shared housing arrangement that is paid for by Medicaid and Marsh has watched as Kayla has exceeded her expectations of living on her own. "Wildly successful" is how she described it.

Robert has been lobbying for mental health care on behalf of his son and many others like him and he explained why he includes a picture of his two sons on the cover of every narrative⁸ that he submits to Lansing, Washington D.C., or even to local governments.

"I feel it's so critical to take the emphasis off of, in this case, a line item budget or a bell curve or an actuarial study, and put the focus back on the individuals who are going to be affected⁹ by any of the changes," White said.

White and Marsh both explained that they have been relatively¹⁰ happy with the care their respective children have received, but that no system is perfect. Marsh points out that in her experience, it's not very user friendly and it can be tough to navigate¹¹, but her main concern is that it is a public system.

"When we stray away from a public system, we're going to lose that public accountability and the transparency," Marsh said. "A private health plan is not subject to the Open Meetings Act and they're not subject to the Freedom of Information Act. So there is no public transparency and accountability. I don't know that Veridian or Molina or Priority Health would welcome me to sit in on a board meeting."

White echoed her concerns as he fears that the quest for profits could get in the way of quality health care for patients.

"When we talk about moving the [mental health care] system away from a public entity¹² ... to managed health care organizations, I think of it, often, as a shift from stakeholders to shareholders," White said. "And what gets lost in shifting the emphasis of why an MCO, that now has responsibility, or an HMO, for behavioral health, why they exist. Do they exist for profitability? Or do they exist for the benefit of maximizing the services that not only our sons, and Gail's daughter and others, deserve, but it's their civil rights, human rights and constitutional rights. It's not an elective."

White said he is not afraid of change, he just wants his family, and other families like his to be a part of that change.

Parents want nothing more than to keep their children safe and happy. But for White and Marsh, the uncertain future of Michigan's mental health care system leaves them feeling anxious because they may not always be there to fight for them.

"My wife and I are afraid to die," White said while fighting back tears. "Every year, we as parents, we aren't going to be around to advocate on their behalf. To make the trips to Lansing, to go to the meetings. We have to come up with something that's more sustainable so that we have the confidence that when we're not here, that our two guys, Gail's daughter and others like them, are going to be taken care of."

Gail echoed those sentiments. "I said that to the group of 135 persons at the Section 298 work group, I told them that myself and other families that I'm aware of, we have a confession¹³, like Bob, are hoping that our sons and daughters don't live longer than we do because we can't trust that there's a system that's going to take care of them."

Listen to the full interview above to hear more about their children and how they rely on mental health services as well as Marsh's examples of how privatizing "doesn't work" and why White describes it as a form of "outsourcing."

1 fiscal   

adj.财政的，会计的，国库的，国库岁入的

参考例句：

• The increase of taxation is an important fiscal policy.增税是一项重要的财政政策。
• The government has two basic strategies of fiscal policy available.政府有两个可行的财政政策基本战略。

2 convened   

召开( convene的过去式 )； 召集； （为正式会议而）聚集； 集合

参考例句：

• The chairman convened the committee to put the issue to a vote. 主席召集委员们开会对这个问题进行表决。
• The governor convened his troops to put down the revolt. 总督召集他的部队去镇压叛乱。

3 affinity   

n.亲和力，密切关系

参考例句：

• I felt a great affinity with the people of the Highlands.我被苏格兰高地人民深深地吸引。
• It's important that you share an affinity with your husband.和丈夫有共同的爱好是十分重要的。

4 marsh   

n.沼泽，湿地

参考例句：

• There are a lot of frogs in the marsh.沼泽里有许多青蛙。
• I made my way slowly out of the marsh.我缓慢地走出这片沼泽地。

5 prospect   

n.前景，前途；景色，视野

参考例句：

• This state of things holds out a cheerful prospect.事态呈现出可喜的前景。
• The prospect became more evident.前景变得更加明朗了。

6 spectrum   

n.谱，光谱，频谱；范围，幅度，系列

参考例句：

• This is a kind of atomic spectrum.这是一种原子光谱。
• We have known much of the constitution of the solar spectrum.关于太阳光谱的构成，我们已了解不少。

7 syndrome   

n.综合病症；并存特性

参考例句：

• The Institute says that an unidentified virus is to blame for the syndrome. 该研究所表示,引起这种综合症的是一种尚未确认的病毒。
• Results indicated that 11 fetuses had Down syndrome. 结果表明有11个胎儿患有唐氏综合征。

8 narrative   

n.叙述，故事；adj.叙事的，故事体的

参考例句：

• He was a writer of great narrative power.他是一位颇有记述能力的作家。
• Neither author was very strong on narrative.两个作者都不是很善于讲故事。

9 affected   

adj.不自然的，假装的

参考例句：

• She showed an affected interest in our subject.她假装对我们的课题感到兴趣。
• His manners are affected.他的态度不自然。

10 relatively   

adv.比较...地，相对地

参考例句：

• The rabbit is a relatively recent introduction in Australia.兔子是相对较新引入澳大利亚的物种。
• The operation was relatively painless.手术相对来说不痛。

11 navigate   

v.航行，飞行；导航，领航

参考例句：

• He was the first man to navigate the Atlantic by air.他是第一个飞越大西洋的人。
• Such boats can navigate on the Nile.这种船可以在尼罗河上航行。

12 entity   

n.实体，独立存在体，实际存在物

参考例句：

• The country is no longer one political entity.这个国家不再是一个统一的政治实体了。
• As a separate legal entity,the corporation must pay taxes.作为一个独立的法律实体，公司必须纳税。

13 confession   

n.自白，供认，承认

参考例句：

• Her confession was simply tantamount to a casual explanation.她的自白简直等于一篇即席说明。
• The police used torture to extort a confession from him.警察对他用刑逼供。