David Bolin spent 30 years working for a tax-exempt organization that provided community-based services to elderly, mentally ill, and intellectually and developmentally disabled individuals.
But now he finds himself in the unexpected position of pushing against the Pennsylvania Department of Human Services' decision to close the civil unit at Norristown State Hospital, where his daughter has been for three years.
It is not that Bolin has not tried to keep his 23-year-old adopted daughter, who has been diagnosed with schizophrenia and other disorders, in the community.
"She's at Norristown State Hospital because no one else would take her," he said at a hearing on the closure Tuesday.
Bolin was among 28 people, including service providers, advocates, hospital employees, family members of patients, and former patients, to testify at the 2½-hour hearing on the campus of Norristown State Hospital, which opened in 1880 and is the only remaining state mental hospital in Southeastern Pennsylvania.
Advocates and providers warned a panel of human services department officials that it will not be easy to place many of the current 122 Norristown inpatients in community settings and that capacity will have to be built.
"The community system is not equipped to handle this high level of need," said Diane Conway, chief executive director of Max, an association of human services agencies in Southeastern Pennsylvania.
Building those capabilities will take a significant amount of money from the cash-strapped state.
"If this closure is to be successful, it can't be done on the cheap," said Alan Hartl, chief executive of the Lenape Valley Foundation, a Doylestown human-services provider.
Even if the government provides money to get through the closure, which is expected to take 18 months to two years, providers worry that it might not last.
"How can we be sure these funding streams won't be cut over time?" Michael Brody, chief executive of the Mental Health Association of Southeastern Pennsylvania, asked the panel.
Ellen Kozlowski, who works for Community Advocates of Montgomery County, was among the former Norristown Hospital patients who testified about how they were able to move to community living with significant support. Kozlowski said she has been living on her own for nine years and working for 12.
But for Kozlowski's sister, who moved to a long-term structured residence in Pottstown, the most restrictive form of care outside a mental hospital, it was a failure, Kozlowski said, and now her sister is scheduled to come back to Norristown.
"If you are not going to have state hospitals, how are you going to take care of people?" she asked the panel.
The state plans to continue operating the forensic unit at Norristown, which is where mentally ill criminal defendants are sent for treatment to make them competent to stand trial, if possible.
When the state announced the closure Jan. 11, it said 30 beds at Wernersville State Hospital, which is west of Reading and at least 50 miles from Norristown, would be dedicated to residents of the five-county Southeastern Pennsylvania area.
Bolin worries that his daughter, who didn't last in a long-term structured residence, is a candidate for transfer to rural Wernersville. "It's definitely not a step up. It's a step backward," he said in an interview Wednesday.
"She's happier here than she's ever been anywhere else," Bolin said of his daughter's time in Norristown.