A Badly Altered State

A judge may force Colorado to take care of its homeless mentally ill population.

But the community mental-health centers never received enough funding to meet the needs of people who required constant monitoring. As hundreds were "deinstitutionalized," it soon became apparent that many were incapable of living on their own. Without mental hospitals, the most vulnerable were left to fend for themselves. Once they were on the streets, many failed to take their medication; others were prone to abuse alcohol and drugs. By the early 1980s, the sight of a homeless man or woman mumbling to themselves and pushing a cart full of possessions was a common one on the streets of downtown Denver.

The lawsuit contains a dozen brief biographies of such people and puts a human face on the abandonment of the mentally ill. The effects of the 1981 closure of a Capitol Hill day clinic for the mentally ill, for instance, are outlined in sorry detail: One man slips into alcoholism, another is thrown into jail, a third takes his own life. All three are repeatedly hospitalized for short periods of time at Fort Logan (the state's primary mental hospital) or Denver General Hospital (now Denver Health Medical Center), then discharged back onto the street.

The case first went to trial in 1982, and a district court judge found in favor of the plaintiffs in 1985. The state then began a series of appeals that reached all the way to the Colorado Supreme Court. The high court ruled in 1988 that the state could be required to take corrective action. In 1990 the state proposed a remedial plan, but legal skirmishes continued over whether the plan was adequate.

Dr. Ed Casper believes the homeless are not getting the medical care they need.
Brett Amole
Dr. Ed Casper believes the homeless are not getting the medical care they need.
Sheryl Silver runs the Ruben L. Valdez Personal Care Center for the homeless and the mentally ill.
Brett Amole
Sheryl Silver runs the Ruben L. Valdez Personal Care Center for the homeless and the mentally ill.

Weary of the endless litigation, all three parties eventually struck a deal in 1993, which was approved by the state Supreme Court in February 1994.

The 250-page settlement called for Colorado to boost spending for care of the chronically mentally ill in Denver by $7 million a year. The state agreed to target 1,600 people with severe problems, including those who were homeless, and the agreement spelled out in great detail exactly what services the state would provide through its contractor, the Mental Health Corporation of Denver (MHCD).

"The plan was to take 1,600 people and give them the services they need," says Mullen. "Case managers would go out to the community and track these people down, making sure they have a place to live, take their medication, get psychiatric support and vocational training." The homeless mentally ill were a priority under the plan.

The agreement also called for the City of Denver to provide 250 units of housing for the mentally ill, which it did only after much delay. The city purchased several homes in quiet residential neighborhoods for group housing and secured one hundred vouchers for subsidized apartments. The vouchers entitled people to live in Section 8 units, a federally subsidized housing program for the poor. The city now spends more than $2 million per year to fund the 250 housing units.

Once Denver found the housing, the state was supposed to pay for the care. But over the next few years, Mullen watched in frustration as perfectly good homes sat empty, waiting for staff. "They didn't have an explanation for why they'd let these units be empty when there was a desperate need," she says. "That they could allow wonderful homes to sit there empty says to me they've lost touch with the people they're supposed to be serving."

So she went back to court in 1997 to force the agreement.

For its part, the state continues to insist that it is meeting all the terms of the settlement, and in fact, many of the empty houses have been filled since Mullen went back to court three years ago.

"We pay about $17 million a year for services to the Goebel clients," says Wade Livingston, the assistant attorney general who represents the state in court. "Our position is that we exceeded [the settlement] terms in a lot of respects. I think our services meet all the legal requirements. Of course, they could always use more services."

Forcing Marva Hammons to stand in line for a bed at a homeless shelter won't solve the problem, either, he adds. "That doesn't seem to be a suggestion calculated to make anything better," he says. "Marva Hammons has a lot of hands-on experience dealing with people in need. The suggestion that she doesn't understand people in need is not fair."

Hammons headed up human-service agencies in Michigan and New York City before being appointed to her current post by Governor Bill Owens last year. Although Hammons was widely criticized in her previous jobs for endorsing budget cuts that may have played a role in the deaths of a six-year-old New York City girl and a Michigan social worker, she hasn't played a key role in the Goebel case, which has been going on since Dick Lamm was governor and throughout former governor Roy Romer's administration.

(Citing the upcoming hearing, a spokeswoman for Hammons referred all questions to Livingston.)

Judge Hoffman disagreed with Livingston's rosy assessment of the situation last spring when he held the state in contempt. For months before, Hoffman had made it clear that he was losing patience with Colorado's lackluster effort to fulfill its end of the bargain.

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